Health Program Representative II

Elevance Health•St. Louis, MO

1d•$17 - $27•Remote

About The Position

Health Program Representative II Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Health Program Representative II is responsible for providing initial contact between distinct Care Management programs and specific identified members. Under general supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features. How you will make an impact: Gathers and records appropriate member information in accordance with policies and procedures via telephone. Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services. Records call details and utilize call scripts as needed based on client requirements. Directs member inquiries to appropriate clinical staff. Initiates referrals and manages consults from clinicians for participants registered in Care Management. Gathers information from hospitals, health plans, physicians, patients, vendors and other referral sources. Contacts physician offices to obtain demographic information or related data as needed. Mentors less experienced Health Program Advocates.

Requirements

HS diploma or the equivalent and a minimum of 6 months experience; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

Able to multi-task strongly preferred.
Strong verbal and written communication skills strongly preferred.
Call center experience strongly preferred.

Responsibilities

Gathers and records appropriate member information in accordance with policies and procedures via telephone.
Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services.
Records call details and utilize call scripts as needed based on client requirements.
Directs member inquiries to appropriate clinical staff.
Initiates referrals and manages consults from clinicians for participants registered in Care Management.
Gathers information from hospitals, health plans, physicians, patients, vendors and other referral sources.
Contacts physician offices to obtain demographic information or related data as needed.
Mentors less experienced Health Program Advocates.