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Corporate Functions & Operations WellCare - Operations Support Careers

Retention Representative Job

Full Job Title: Retention Representative

Job Number: 1704019

Location: Cypress, CA

Date Posted: 8-29-2017

This position is forEasy Choice Health Plan Cypress, CA, a WellCare Healthplans, Inc. company.

Contacts post-enrollment beneficiaries for retention support and conducts sales agent compliance audits.

Department: CA- State Operations
Reports to: Sr Mgr, State Operations
Location: 10803 Hope Street Suite B, Cypress, CA 90630
Job Type: Hourly/Non-exempt

Essential Functions:
  • Makes outbound calls to newly enrolled members (30 days, 60 days, & 90 days after enrollment is initiated) to discuss the HMO process, assist with scheduling appointments, answer benefit questions, & assist with preventative care education to increase HEDIS and STARS.
  • Makes outbound calls to disenrolled members to survey member's dissatisfactions and identify process improvement opportunities. Follows compliance guidelines and provide feedback to help identify areas of improvement.
  • Inputs retention and compliance tracking into a database for the purpose of tracking, trending, & reporting.
  • Performs member outreach to assist Health Services in closing care gaps.
  • Participates in the Member Navigation program which provides members with personal health care representatives that assist them in navigating through the managed care process.
  • Assists Network Management in obtaining patient charts for the purposes of increasing RAPS scores.
  • Identifies opportunities to improve the process for outbound calls, member contact and surveys.
  • Performs other duties as assigned.
Candidate Education:
  • Required A High School or GED
  • Preferred An Associate's Degree in a related field
Candidate Experience:
  • Required 2 years of experience in outbound sales or customer service
Candidate Skills:
  • Intermediate Demonstrated customer service skills
  • Beginner Ability to effectively present information and respond to questions from families, members, and providers
  • Beginner Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
  • Beginner Ability to work independently
  • Intermediate Demonstrated interpersonal/verbal communication skills
  • Beginner Demonstrated problem solving skills
  • Beginner Demonstrated time management and priority setting skills
  • Beginner Knowledge of healthcare delivery
Technical Skills:
  • Required Beginner Microsoft Outlook
  • Required Beginner Microsoft Word
  • Required Beginner Other Ability to learn and use reporting tools (Crystal, Discovery, etc.)
  • Preferred Beginner Microsoft Excel
  • Required Spanish

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Last Updated On: 12/9/2015