Personal Care Connector

Personal Care Connector: Medicaid/Medicare, Call Center Experience

United States Category Medical Management and Quality Job Id 44339 Remote

Application Instructions:

Make sure your resume has been customized to the role shown in the job posting. Email your custom resume to me: thomas.lepera@montgomerycountypa.gov. I will review your resume. If there is a match, then I will email you a link to the application with further instruction. When applying remember to select PA CareerLink as your referral. After I sent the link and you apply then email to let me know so I can follow up on your application.

Role Overview: 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.

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.

Education & Experience:

High School Diploma or GED required. 3 to 5 years in a call center environment with proven ability to manage high call volumes. 2 to 4 years of experience with Medicare and Medicaid (preferred). Healthcare industry experience is a plus. Proficient in Microsoft Office Suite (Word, Excel, etc.) and capable of navigating multiple systems simultaneously.

Skills & Abilities:

Strong verbal and written communication skills. Ability to multitask, think critically, and resolve issues efficiently. Knowledge of health plan benefits and services is preferred. Dependable with a strong attendance record.

What's in it for you: Use your skills and experience to help others as well take advantage of our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.