Responds to incoming customer calls a nd a ssists enrollees in selecting a CCN a nd indicating a PCP preference, request a change in PCP, responds to requests for general information a bout a ccessing services in the Louisiana GNOCHC, CCN, or a lternative Medicaid managed care programs; discusses problems, resolves issues, a nd documents complaints.
Processes enrollment, disenrollment, a nd other member inquiries.
Educates members on managed care, 90 day choice period, continuous enrollment materials, a nd a nnual enrollment.
Maintains updated knowledge of a ll Louisiana GNOCHC, CCN, or a lternative
Medicaid managed care program information, a nd policies a nd procedures a nd program changes.
Remains courteous, helpful, a nd sensitive to consumer needs a t a ll times.
Remains unbiased a nd maintains consumer confidentiality.
Raises issues of concern a nd/or problems to the a ttention of a Call Center Lead or Call Center Supervisor.
Conducts research a nd follows up on problematic cases a s needed.
Performs other duties a s may be a ssigned by management.
The Ideal Candidate will Possess the Following A dditional Education a nd Experience:
A ssociate’s degree or relevant years of experience preferred
Two years of human services a nd or customer service experience a nd knowledge of the community to be served desirable
Proficiency a nd understanding of personal computing sufficient to work effectively with the reports a nd a utomation a ssociated with the Louisiana Enrollment Broker project
A bility to deal effectively with enrollees a nd potential enrollees
A bility to interact courteously a nd effectively with culturally diverse populations; strong organizational, written a nd verbal communication skills
A bility to perform comfortably in a fast-paced, deadline-oriented work environment
A bility to successfully execute many complex tasks simultaneously
A bility to work a s a team member, a s well a s independently; bi-lingual capabilities a plus.
Training in Medicaid managed care, the Louisiana Department of Health a nd Hospitals, Louisiana Medicaid a nd LaCHIP, a nd the individual managed care programs desired.
This training will be provided a s needed.
MAXIMUS (NYSE: MMS) is a leading health a nd human services a dministrator for governments in the United States, United Kingdom, Canada a nd A ustralia. We deliver a dministrative solutions to improve the cost effectiveness, efficiency a nd quality of government-sponsored benefit programs a cross the globe. Operating under our founding mission of Helping Government Serve the People ®, we have more than 7,000 employees located in more than 220 offices worldwide. MAXIMUS is a n A ffirmative A ction a nd Equal Opportunity employer.
Education Required: High School Diploma or GED
Education Preferred: A ssociates a nd/or Bachelors degree from a n a ccredited college or university
Technical Skills / Knowledge Preferred: Bilingual capabilities preferred
Subject Matter Expertise/Experience Required : 0 - 2 years of related job experience
Subject Matter Expertise/Experience Preferred : Experience working with culturally/linguistically diverse a nd disadvantaged populations in a courteous a nd effective manner
Personal/Soft Skills: Organizational, interpersonal, written, verbal a nd communication skills, a bility to perform comfortably in a fast-paced, deadline-oriented work environment, a bility to successfully execute many tasks simultaneously, a bility to work a s a team member, a ttentional to detail, a s well a s independently a nd a bility to work under standards- based performance measures
Duties / Responsibilities:
1. Respond to inquiries related to various customer service a ctivities
2. Participate a s necessary in specialized projects, work groups a nd committees a imed a t evaluating project needs, improving services, a nd implementing new service strategies
3. Ensure work a rea is secure of confidential materials, organized, a nd fully stocked of a ppropriate paperwork a t the beginning a nd end of each shift
4. Initiate outbound calls a nd respond to incoming customer calls in order to a ssist internal a nd external clients
5. Maintain a ccurate case records for the participant, both hard copy a nd in computer information systems
6. Submit reports a s directed by management
7. Perform other duties a s may be a ssigned by management
MAXIMUS offers a comprehensive benefits package including:
Healthcare Insurance (medical, dental, vision)
Short a nd Long Term Disability Insurance
Life/ A ccident Insurance
Flexible Spending A ccounts (FSA)
401(k) Retirement Plan with company match
Our benefit program a lso includes paid holidays, PTO, tuition reimbursement, a nd supplemental insurance (pet ins., a uto ins., legal plan, long-term care ins, a nd credit union).
MAXIMUS - 13 months ago
MAXIMUS (NYSE:MMS) is a leading health and human services administrator for governments in the United States, United Kingdom, Canada and...