CareMore Patient Relations Representative-5

CareMore Health Management Services, LLC; Downey (CA); On-site; USD 29,000 - 44,000; Full time

Job summary

CareMore Health Management Services, LLC is seeking a Patient Relations Representative in Downey, CA to advocate for patients, navigate insurance benefits, and coordinate care across clinical teams. You will address barriers to access, support onboarding, and educate on public programs.

The role emphasizes strong communication, problem-solving, and community engagement to enhance patient satisfaction and program participation.

Qualifications

• Strong communication, interpersonal, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.
• Public speaking and presentation skills are a plus.

Responsibilities

• Serve as a primary point of contact for patients regarding insurance, benefits, and access-to-care questions.
• Assist patients in understanding Medicare, Medicaid, and health plan benefits, eligibility, and coverage options.
• Help resolve patient concerns related to appointments, referrals, billing, and care coordination.
• Advocate for patients by identifying and addressing barriers to healthcare access and treatment adherence.
• Educate patients on available public assistance and healthcare support programs.
• Assist patients with applications and documentation for eligible programs and services.
• Support patient onboarding and orientation to CareMore services and programs.
• Build strong relationships with patients and caregivers to foster trust and satisfaction.
• Promote preventative care and encourage participation in health management programs.
• Serve as a resource for insurance and benefit-related questions.
• Participate in team meetings, case reviews, and patient experience initiatives.
• Support organizational goals related to patient satisfaction, retention, and quality outcomes.
• Partner with clinic leadership and interdisciplinary teams to improve patient workflows and service delivery.
• Support scheduling coordination, documentation, reporting, and operational processes as needed.
• Maintain accurate patient records and ensure confidentiality in compliance with HIPAA standards.
• Participate in quality improvement initiatives focused on patient experience and operational excellence.
• Partner with SHIP/HICAP to educate SHIP on CareMore resources and understand available to our patients/Medicare beneficiaries.

Skills

Communication

Problem-solving

Multitasking

Public Speaking

Relationship Building

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Job description

Job Description SummaryThe Patient Relations Representative serves as a trusted advocate and resource for CareMore patients, helping them navigate healthcare services, insurance coverage, and access to care. This role is responsible for delivering an exceptional patient experience by supporting patient engagement, resolving barriers to care, and collaborating closely with clinical and operational teams to ensure patients receive coordinated, high-quality service throughout their healthcare journey.The Patient Relations Rep acts as a liaison between patients, providers, health plans, and community resources while supporting operational initiatives that improve patient satisfaction, retention, and overall care outcomes.How will you make an impact & RequirementsKey ResponsibilitiesBenefit NavigationServe as a primary point of contact for patients regarding insurance, benefits, and access-to-care questionsAssist patients in understanding Medicare, Medicaid, and health plan benefits, eligibility, and coverage optionsHelp resolve patient concerns related to appointments, referrals, billing, and care coordinationAdvocate for patients by identifying and addressing barriers to healthcare access and treatment adherenceEducate patients on available public assistance and healthcare support programsAssist patients with applications and documentation for eligible programs and servicesPatient ExperienceSupport patient onboarding and orientation to CareMore services and programsBuild strong relationships with patients and caregivers to foster trust and satisfactionPromote preventative care and encourage participation in health management programsServe as a resource for insurance and benefit-related questionsParticipate in team meetings, case reviews, and patient experience initiativesSupport organizational goals related to patient satisfaction, retention, and quality outcomesOperational & Administrative SupportPartner with clinic leadership and interdisciplinary teams to improve patient workflows and service deliverySupport scheduling coordination, documentation, reporting, and operational processes as neededMaintain accurate patient records and ensure confidentiality in compliance with HIPAA standardsParticipate in quality improvement initiatives focused on patient experience and operational excellenceCommunity EngagementPartner with SHIP/HICAP to educate SHIP on CareMore resources and understand available to our patients/Medicare beneficiariesIdentify key community organizations who can contribute to the overall wellbeing of our membershipParticipate in community outreach to support organizational net growthQualificationsRequired QualificationsHigh School Diploma or GED3+ years of experience in healthcare operations, patient relations, customer service, or care coordinationExperience working with Medicare, Medicaid, or managed care populations preferredStrong communication, interpersonal, and problem-solving skillsAbility to manage multiple priorities in a fast-paced healthcare environmentProficiency in Microsoft Office Suite and healthcare systems/platformsComfortable with public speaking, possess effective presentation skillsPreferred QualificationsBA/BS in a related FieldBilingual skills preferred (Spanish)Experience in patient advocacy, community outreach, or health plan operationsKnowledge of healthcare compliance and patient privacy regulationsCA health insurance licenseCore CompetenciesPatient-centered serviceRelationship building and communicationOrganizational and operational excellenceCollaboration and teamworkProblem-solving and conflict resolutionAdaptability and initiativeConfidentiality and professionalismCompensation Range:$29.04to$43.56The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.