Personal Care Connector

Amerihealth Caritas•,

9d•Hybrid

About The Position

The Personal Care Connector (PCC) is vital in delivering high-quality, personalized service to Medicare members. Operating within a call center environment, the PCC supports daily functions of the Personal Service Program, Integrated Care Management, and Utilization Management initiatives. This role involves direct interaction with members, providers, and internal teams to ensure seamless access to care, resolution of issues, and promotion of health plan benefits and community resources.

Requirements

High School Diploma or GED required.
3 to 5 years in a call center environment with proven ability to manage high call volumes.
Proficient in Microsoft Office Suite (Word, Excel, etc.) and capable of navigating multiple systems simultaneously.
Strong verbal and written communication skills.
Ability to multitask, think critically, and resolve issues efficiently.
Dependable with a strong attendance record.

Nice To Haves

2 to 4 years of experience with Medicare and Medicaid (preferred).
Healthcare industry experience is a plus.
Knowledge of health plan benefits and services is preferred.

Responsibilities

Handle inbound and outbound calls from members and providers, ensuring timely and effective service aligned with performance metrics.
Identify care gaps and HEDIS-related health conditions, guiding members to appropriate care and resources.
Support clinical teams by managing transactions, resolving issues, and providing educational materials.
Document case notes accurately while engaging with members over the phone.
Educate members on plan benefits, services, and community support options.
Facilitate communication between members and provider offices to reduce barriers to care.
Meet or exceed call quality, documentation, compliance, and attendance performance standards.