Member Access & Care Liaison Specialist

CalOptima; Orange (CA); Hybrid; USD 60,000 - 75,000; Full time

Benefits offered by this job

Benefits package

Generous PTO

Tuition Reimbursement

Flexible scheduling

Career development opportunities

Job summary

CalOptima Health in Orange, CA is seeking a Member Liaison Specialist to provide compassionate member service to seniors, people with disabilities, and other community members. You will act as a bridge between members, health networks, providers and community organizations to access services and address psychosocial needs.

The role requires a high school diploma and 2 years in health care call center or customer service, with the ability to coordinate care, document cases in the FACETS system,

Qualifications

• Requires high school diploma or equivalent plus 2 years’ experience in health care call center or customer/member services.
• Strong communication and interpersonal skills for diverse member needs.
• Ability to coordinate care and access to services across networks and providers.

Responsibilities

• Provide member service to seniors, persons with disabilities, and other eligible members.
• Intake and route inquiries, grievances, and referrals per guidelines.
• Coordinate members' health and social service needs within and outside the health network.
• Maintain documentation of cases in the FACETS system.
• Meet regulatory KPIs and achieve first-call resolution goals.
• Collaborate with interdepartmental staff to support department objectives.

Skills

Customer service

Communication skills

Multitasking

Education

High school diploma or equivalent

Tools

Microsoft Office

FACETS system

Job description

CalOptima Health in Orange, CA is seeking a Member Liaison Specialist to provide compassionate member service to seniors, people with disabilities, and other community members. You will act as a bridge between members, health networks, providers and community organizations to access services and address psychosocial needs.

The role requires a high school diploma and 2 years in health care call center or customer service, with the ability to coordinate care, document cases in the FACETS system,