Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

 

Primary Purpose

Responsible for retaining current membership by assisting members with the completion and processing of Government health program applications; responds to all inquiries regarding the application process from both new and existing members and strives to meet daily production metrics designed to achieve higher membership retention.

This position reports under the Community Engagement organization and works regularly with the Marketing and Operations organizations to drive out program strategy and approach.

 

Minimum Specifications

 

Education

High School Diploma or GED required. Associates Degree or Bachelors Degree preferred.

 

Experience

1-2 years' customer service or sales experience required. Minimum 1 year experience in healthcare, managed care insurance or financial services preferred. Experience with federal, state and/or local statutes and guidelines preferred. Bi-lingual Spanish Speaking preferred.

 

Equivalent Education and/or Experience

May have an equivalent combination of education and experience to substitute for both the education and the experience requirements.

 

Certification/Registration/Licensure

Current and valid driver’s license required.

 

Skills or Special Abilities

Attention to detail with focused accuracy. Demonstrated ability to think strategically. Knowledge of managed care/Medicaid program processes. Deliver clear written and oral communications. Apply critical thinking and analysis. Ability to manage time appropriately.

 

Responsibilities

Provide member resolution by researching, analyzing, and documenting inquiries regarding program eligibility. Answer application and/or service questions regarding PCHHP programs and services to maintain/attract membership. Conduct outreach and follow up calls to educate members about PCHP and close the loop on outstanding recertifications/applications. Develop and maintain relationships with existing members by providing guidance and assistance throughout the recertification process. Working with management, utilize root cause analysis skills to identify and resolve member related issues with external stakeholders. Complete all required paperwork and documentation necessary to complete the application process; track and input actions taken during the recertification process to ensure all member accounts correctly reflect activities performed. Document and track all interactions in the appropriate system (I.E. Sales Force, Onvida) to ensure all member accounts correctly reflect activities performed.

 

Job Accountabilities

Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of PCHP. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding.

 

Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status. As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus.