Care Navigator

Spectraforce Technologies, Inc.; Raleigh (NC); Remote; USD 28,000 - 39,000; Full time

Job summary

Spectraforce Technologies, Inc. is seeking a Care Navigator for a remote health plan call center role supporting STAR+PLUS members. You'll join the MSC Department, handle inbound calls, educate enrollees on benefits, coordinate transportation, and assist with ID cards and PCP changes.

Candidates should have HS Diploma, strong customer service, and prior call center or Medicaid experience. Remote work, standard CST-like hours, potential OT, and multi-shift coverage are offered.

Qualifications

• Must have strong customer service and call center experience.
• Experience with Medicaid programs and managed care is a plus.
• Background in coordinating services for vulnerable populations is beneficial.

Responsibilities

• Inbound call center, assist and educate Medicaid members on benefits and Services such as PCP Changes, ID Cards and Coordinate transportation and other services.

Skills

Customer service, call center

Computer knowledge

Insurance, MCO background

Education

HS Diploma

Tools

Microsoft Office Suite

Avaya

Zoom

Skype

Job description

Position Title:

Care Navigator

Work Location:

Remote, TX

Assignment Duration:

4 Months (Possibility to extend or convert )

Work Schedule:

Hours of operation is 8-6:30 CST. Four different shifts: 8:30-5, 9-5:30, 9:30-6, 10-6:30. Lunch break: 1 hour during training, once assigned shift 30 minutes & 2 15-minute breaks. OT potential - can support other departments with authorization.

Work Arrangement:

Remote

Position Summary:

Health Plan Call Center. Would be working with MSC Department and assisting in taking calls for our STAR+PLUS member. Team is to cover and answer calls that come in through call center. This is to cover the SCs who are out in LOA, FMLA and the openings we have open. Self-starters, eager to learn, great customer service. Each day, they will interact with different members, learning from them and assisting with their individual needs.

Background & Context:

These positions work in a Call Center setting where the contractors are on a phone queue.

Key Responsibilities:

• Inbound call center, assist and educate Medicaid members on benefits and Services such as PCP Changes, ID Cards and Coordinate transportation and other services.

Qualification & Experience:

Candidate Requirements

Education/Certification

Required: HS Diploma

Preferred: BUT NOT Required: BA in Social Work or Healthcare Mgmt, LVN, CNA, CMA, RT, Pharmacy Tech

Licensure

Required:

Preferred:

Years of experience required:

Over 5 years of experience working directly with the ABD (Aged, Blind, and Disabled) population in call center environments, Medicaid programs, and Managed Care Organizations (MCOs). Skilled in supporting individuals with disabilities and vulnerable populations managing chronic or complex health conditions. Demonstrated expertise in providing care coordination for children, young adults, and other high-need groups within the past three of the last five years.

Must haves: good attendance, call center background; worked with MCO insurance

Nice to haves: background in Service Coordination, and call center experience.

Disqualifiers: no call center experience

Additional qualities to look for: Software Skills: Will be using various software on the job: Microsoft Office Suite, Avaya, Zoom, Skype

Top 3 must-have hard skills stack-ranked by importance

• Customer service, call center experience
• Computer Knowledge
• Insurance, MCO background.