Health Program Representative

• Provide initial contact between Care Management programs and identified members
• Handle inbound and outbound enrollment and engagement calls under direct supervision
• Gather and record member information by telephone according to policies and procedures
• Encourage members to participate in Care Management programs by explaining features, value and available services
• Record call details and use call scripts as required by clients
• Direct member inquiries to appropriate clinical staff
• Initiate referrals and manage clinician consults for Care Management participants
• Gather information from hospitals, health plans, physicians, patients, vendors and referral sources
• Contact physician offices to obtain demographic or related data
• Handle calls, texts, facsimiles and electronic queues while taking notes and speaking with customers
• Work a structured schedule with occasional overtime or flexibility based on business needs
• Perform other duties as assigned

• HS diploma or equivalent
• Minimum of 6 months experience in telesales or customer service, or an equivalent combination of education and experience
• Computer/keyboarding proficiency strongly preferred
• Knowledge of company products, services and benefits preferred
• Ability to work Monday–Friday, 9 AM–5:30 PM EST
• Ability to multitask while handling calls, texts, facsimiles and electronic queues
• Proficiency with digital tools and platforms
• Strong verbal and written communication skills
• Attention to detail, critical thinking and problem-solving skills
• Empathy and persistence in resolving caller issues
• Ability to maintain focus during extended periods of sitting and work in a fast‑paced, high‑pressure environment
• Ability to work from the office as necessary
• New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza unless an acceptable explanation is provided

Demonstrates strong verbal and written communication skills while effectively managing member inquiries and engagement in Care Management programs. Proficient in multitasking and utilizing digital tools to gather and record member information accurately.

• Customer Service Experience
• Telesales Experience
• Computer/Keyboarding Proficiency
• Digital Tools Proficiency
• Attention to Detail

• Data Gathering
• Call Management
• Referral Initiation
• Information Recording
• Engagement Techniques

• Empathy
• Critical Thinking
• Problem‑Solving
• Persistence
• Attention to Detail

• COVID-19 Vaccination
• Influenza Vaccination

• Care Management
• Member Engagement
• Health Plans
• Patient Interaction
• Clinical Staff Coordination

• Call Scripts
• Electronic Queues
• Facsimiles
• Text Communication
• Digital Platforms