Remote Work Requirements
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.
About AmeriHealth Caritas
Your career starts now. We're looking for the next generation of health care leaders.
At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
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.
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.