Member Services Navigator - (CA) Bilingual (Chinese/English)

Johnson Service Group

CA(remote)

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JOB DETAILS

SALARY

$29–$34 Per Hour

SKILLS

Behavioral Health, Chinese Language, Clinical Information, Customer Support/Service, English Language, Follow Through, Health Insurance, Health Plan, Healthcare, High School Diploma, Legal, Medical Assistance, Medications, Microsoft Access Database, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft PowerPoint, Microsoft Word, Multilingual, Prescription Drugs, Problem Solving Skills, Provider Contracting

LOCATION

POSTED

9 days ago

Johnson Service Group (JSG) is seeking a Member Services Navigator for a Health Plan in California. Must be Bilingual English/Chinese speaker.
This is a remote opportunity.
Work schedule: Monday - Friday 8am-5pm
Pay range: $29.00-$34.00 DOE

General Description:
Act as the primary point of contact for members of CareAdvantage D-SNP and CareAdvantage CMC and assist members with all aspects of plan benefits.

Duties & Responsibilities
Essential Functions:
Provide customer service to CareAdvantage members primarily on the phone.
Answer member questions about CareAdvantage health and prescription drug benefits, eligibility, and provider network.
Make New Member Welcome Calls.
Resolve problems that members have accessing CareAdvantage-covered services, including but not limited to health care services and prescription medications.
Ensure that assigned members retain CareAdvantage enrollment by investigating and contacting members and partnering agencies.
Clearly document any members complaints, including grievances and appeals.
Follow through with proactive solutions to resolve member issues.
Prepare and submit requests for services made directly by a member to HPSM Health Services.
Prepare and submit member requests for continuity of care with non-contracted providers to Provider Services Department.
Refer members to appropriate community partner agencies depending on specific circumstances including but not limited to: Behavioral Health and Recovery Services, Aging and Adult Services, Legal Aid and/or HICAP when appropriate.
Relay pertinent health information to HPSM clinical staff to facilitate care coordination and/or receipt of medical services including prescriptions.
Participate in and professionally represent HPSM at health fairs, community partnerships, meetings, committees, and coalitions as requested by the Manager or Supervisor.
Secondary Functions:
Perform other duties as assigned.
Qualifications
The following represents the typical way to achieve the necessary skills, knowledge and ability to qualify for this position:
Education and experience equivalent to:
Equivalent to a high school diploma or GED required.
Two (2) to three (3) years experience performing customer service preferably in a health plan environment.
Previous experience working with seniors or persons with disabilities and/ in a medically related field such as medical assisting.
Knowledge of:
Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access, and PowerPoint.
Health Insurance programs preferred.
Customer service principles and practices.

JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800

About the Company

Johnson Service Group

At JSG, We Understand People

It is our mission to empower people, help our clients reach their goals, and hire motivated individuals.

Since our start in 1984, we’ve worked hard to establish our present position as the most effective cross-industry staffing and consulting solution available.

Headquartered in Chicago, IL with local offices throughout the United States and Canada, JSG proudly serves a diverse range of industries with the right solutions to help clients reach their company goals. Our client-centric approach enables us to create personalized solutions for businesses in need of top-tier talent. Our dedication doesn’t stop at our clients. We strive to connect candidates with opportunities that match their skills and goals. More than just a go-between, we are a dependable bridge, uniting top talent with suitable opportunities, facilitating shared opportunities and growth.

COMPANY SIZE

1,000 to 1,499 employees

INDUSTRY

Staffing/Employment Agencies

FOUNDED

1984

WEBSITE

https://www.jsginc.com/

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