Hybrid Enrollment & Retention Specialist (Bilingual)

Blue Shield of California; California; Hybrid; USD 30,000 - 41,000; Full time

Job summary

Blue Shield of California Promise Health Plan is seeking an Enrollment and Retention Specialist to educate callers on Medi-Cal enrollment and eligibility, supporting retention goals. The role includes assisting with annual redetermination and advocacy with agencies, while ensuring compliance and documentation.

The successful candidate will contribute to growth programs, interact with callers via phone, and support testing new processes and system enhancements as needed.

Qualifications

• High school diploma or GED, or equivalent experience.
• At least 3 years of relevant experience.
• Strong knowledge of Medi-Cal program and managed care products/services.
• Bilingual in Spanish.
• Maintaining active compliance certifications.

Responsibilities

• Handle day-to-day growth and retention calls meeting department standards.
• Provide eligibility and enrollment information to identify best Blue Shield product.
• Facilitate member enrollment with Federal, State and Local County agencies, escalating complex cases as needed.
• Assist existing members to stay in any Blue Shield product.
• Follow up thoroughly and manage tracking systems for cases.

Skills

Bilingual in Spanish

Medi-Cal knowledge

Active compliance certifications

Education

High School Diploma or GED or equivalent experience

Job description

Blue Shield of California Promise Health Plan is seeking an Enrollment and Retention Specialist to educate callers on Medi-Cal enrollment and eligibility, supporting retention goals. The role includes assisting with annual redetermination and advocacy with agencies, while ensuring compliance and documentation.

The successful candidate will contribute to growth programs, interact with callers via phone, and support testing new processes and system enhancements as needed.