Medicare Member Care Coordinator

Community Health Group; Chula Vista (CA); On-site; USD 79,000 - 91,000; Full time

Job summary

Community Health Group seeks a dedicated Customer Service/Case Manager to enhance Medicare member satisfaction from our Corporate Headquarters in Chula Vista, CA. The role collaborates with multiple departments to respond to member concerns and coordinate needed services.

You will conduct home visits, help members access STARS/HEDIS services, gather contact information, and ensure timely resolution of issues while occasionally traveling within San Diego County.

Qualifications

• Bachelor’s degree in health or human services required.
• Two years of customer service experience preferred.
• Bilingual abilities and sensitivity to cultural needs are valued.

Responsibilities

• Gather information to improve Medicare member health outcomes.
• Conduct home visits for assigned case load.
• Assist members in obtaining STARS/HEDIS related services.
• Contact members via phone/email and coordinate care options.
• Resolve Medicare member concerns in a timely manner.
• Coordinate urgent care, interpreter services, transportation, and prior authorizations.

Skills

Customer service

Communication skills

Bilingual (English/Spanish)

Independent judgment

Driver's license

Education

Bachelor's degree in Health or Human Services

Job description

Community Health Group seeks a dedicated Customer Service/Case Manager to enhance Medicare member satisfaction from our Corporate Headquarters in Chula Vista, CA. The role collaborates with multiple departments to respond to member concerns and coordinate needed services.

You will conduct home visits, help members access STARS/HEDIS services, gather contact information, and ensure timely resolution of issues while occasionally traveling within San Diego County.