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ECM Enrollment Representative - Remote

Role overview

Qualifications

  • High School diploma or equivalent
  • 1-2 years' experience in healthcare environment, social services or community-based organizations a plus
  • Call center or other sales experience
  • Availability to work a 1:00 pm to 9:00 pm shift

Responsibilities

  • Outreach and consent potential members
  • Accurately complete enrollment and eligibility documentation for consented individuals
  • Maintain accurate records in technology platform for all outreach attempts
  • Complete warm transfers to local navigators to continue with member’s care

Key facts

  • Remote from: Texas (USA)
  • Full time
  • Junior (1-2 years)
  • English, Spanish

Other skills

  • Communication
  • Problem Solving
  • Empathy
  • Relationship Building
  • Self-Motivation

About the company

MedZed logo

MedZed

Home Health Care

MedZed is a provider of services and supports to address the Health-Related Social Needs (HRSNs) of high-risk, high-need individuals with complex unmet clinical and social needs who have become effectively disengaged from primary healthcare. We partner with Medicaid Managed Care Plans, Medicare Advantage Plans and risk-bearing provider organizations to find, engage, care for and, ultimately re-integrate these members back into primary care. Our locally-based teams work in-person with members to navigate providers, community organizations and resources, and bring guidance and compassionate support every step of the way. By doing so, MedZed simultaneously addresses the essential human needs of these at-risk individuals while tackling the business challenges of reducing inappropriate utilization and total cost of care.

Company details

IndustryHome Health Care
Company size201 - 500

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Job description


Position Title: MedZed Enrollment Representative

Department: Operations

Reports To: ECM Administration and Enrollment Manager

Location: Remote

Employment Type: Full-time

Travel Requirement: None

About MedZed 

MedZed is a leader in delivering value-based, technology-enabled social support to a diverse population of high-cost Medicaid members who have been unreachable with telephonic outreach, disconnected from primary care, and using hospital-based services as their primary point of care. We combine innovative technologies with field-based outreach to find and engage these members. We then apply a model of care designed to re-connect them to primary care, address the health-Related Social Needs (HRSNs) that contribute to their disengagement and present barriers to care, and provide them with the means and knowledge to take more control over their healthcare.  Our interventions yield reduced Emergency Department and Inpatient utilization costs for our health plan partners and improved quality of life for their members as we scale.

Position Overview

The Enrollment Representative for the ECM program will connect underserved individuals with Community Health Navigators. The Enrollment Representative handles billable activities as needed and works independently with minimal supervision. This candidate will complete outbound calls, consent members into ECM program and connect the members to their local navigator for ongoing services and support. The ideal candidate is a persistent, self-motivated, conscientious, empathetic problem-solver with skills that allow them to engage, build trust and enroll qualified members from the community. 

Key Responsibilities

 

  • Outreach and consent potential members 
  • Accurately complete enrollment and eligibility documentation for consented individuals.
  • Maintain accurate records in technology platform for all outreach attempts
  • Complete warm transfers to local navigators to continue with member’s care.
  • Complete case conferences with Clinical Advisors and Reviewers as needed.
  • Compliance with HIPAA and fulfilling mandated reporting requirements.

Qualifications

  • High School diploma or equivalent
  • 1-2 years’ experience in healthcare environment, social services or community-based organizations a plus
  • Call center or other sales experience
  • Availability to work a 1:00 pm to 9:00 pm shift
  • Excellent written and verbal communication skills 
  • Bi-lingual English and Spanish

 


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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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