Steward Health Choice is dedicated to improving the health and well-being of the people and communities we serve.
Steward Health Choice believes in a personal approach to health care right in your community. We built our health care plan around you. Our goal is to give you quality health care, programs, and services to support you on your path to wellness.
Steward Health Choice provides exceptional customer service and culturally competent care through:
- Compassionate and responsive member services team
- Collaboration with community physicians to help members get the health care they need.
- Providing culturally competent health care, including extensive translation and interpretation services
- Health programs to help members and their families stay healthy
Position Purpose: The Contact Center Buddy is a single point of contact for members for all things related to the health plan. A Contact center Buddy assists members in navigating the health plan and executes activities such as (but are not limited to); find quality doctors, schedule appointments, communicate with internal and external partners (case managers, providers, claims etc.), resolve member issues.
- Provide inbound and outbound communication and develop a relationship with members
- Assist with wellness campaigns to ensure successful outcomes
- Educate members on wellness programs to better manage a health condition or disease
- Conduct member interactions through multiple channels such as telephone, email, mail
- Complete any necessary paperwork and facilitate the processing of prior authorization requests, case management referrals, bill problems, pharmacy issues etc.
- Obtain all medical information needed for determination and forward to clinical reviewers when criteria is not met
- Coordinate authorizations after the initial 7-day authorization has expired
- Complete outbound member retention calls
- High School Diploma or equivalent GED
- Associates degree or higher preferred
Years of Experience:
- At least two (2) years customer service preferred
- At least 1 year Health plan experience preferred
- Previous Medicaid/Medicare experience preferred
- Knowledge of Microsoft office; Word, Excel
- Knowledge of Medicare and Medicaid regulations and guidelines preferred
- Effective time management skills
- Strong ability to logically resolve issues and interpret findings
- Ability to manage multiple tasks and prioritize work to adhere to deadlines and identified time frames
- Work cooperatively, positively, and collaboratively in an interdisciplinary team