Participant Service Representative

Connecticut-Community-Care; Bristol (CT); On-site; USD 42,000 - 54,000; Full time

Job summary

Connecticut Community Care is seeking a Participant Services Representative to provide exceptional customer service, navigate the self-directed Community First Choice program, and offer technical and administrative support to participants and their representatives.

You will explain program requirements, adapt communication to individual needs, support outreach and documentation, and collaborate with families, staff, and external partners while maintaining confidentiality and HIPAA compliance.

Qualifications

• Associate degree or equivalent education/experience considered.
• Experience in customer service, human services, healthcare, aging or disability services, social services, or related field.
• Strong interpersonal, verbal, and written communication skills.
• Ability to explain complex program requirements clearly and compassionately.
• Strong organizational, problem-solving, follow-through, and documentation skills.
• Ability to manage multiple priorities and work independently and collaboratively.
• Proficiency with Microsoft Office and electronic record systems.
• Knowledge of Community First Choice, Medicaid, self-directed services, or HCBS programs preferred.

Responsibilities

• Serve as a primary point of contact for participant questions related to the Community First Choice program.
• Provide customer service, program navigation, technical assistance, and administrative support.
• Help participants and representatives understand program requirements, responsibilities, documentation, timelines, and next steps.
• Adapt communication and support approaches to individual needs and preferences.
• Promote a positive participant experience through responsive communication and follow-up.
• Support outreach, quality assurance, and follow-up related to program participation.
• Maintain accurate participant information and documentation per CCC and state requirements.
• Escalate participant questions or issues requiring clinical or supervisory review.
• Collaborate with participants, families, representatives, stakeholders, and internal teams.
• Maintain confidentiality and comply with HIPAA, DSS requirements, and CCC policies.

Skills

Customer service

Communication

Documentation

Organization

Team collaboration

Education

Associate degree

Tools

Microsoft Office

Job description

Mission

Connecticut Community Care helps people of all ages, abilities, ethnicities and incomes live

their best lives at home with active and meaningful connections to their communities.

Summary

The Participant Services Representative provides exceptional customer service, program navigation,

technical assistance, and administrative support to participants and their representatives enrolled in

Connecticut's self-directed Community First Choice program. In this role you will serve as a

knowledgeable and compassionate resource helping participants understand their rights and

responsibilities within the self-directed service model while empowering them to successfully manage

their own care. This position plays a key role in supporting effective program operations through proactive

outreach, accurate documentation, timely follow-up, and meaningful collaboration with internal teams and

external stakeholders. At CCC, all duties are performed in a manner that fosters the achievement of the

organization's mission.

Essential Functions

• Serve as a primary point of contact for participant and representative questions related to the Community First Choice program.
• Provide exceptional customer service, program navigation, technical assistance, and administrative support.
• Assist participants and representatives in understanding program requirements, responsibilities, documentation, timelines, and next steps.
• Adapt communication and support approaches to meet the needs and preferences of individuals participating in the program.
• Promote a positive participant experience through responsive communication, problem-solving, and timely follow-up.
• Support participant outreach, quality assurance activities, and follow-up related to program participation.
• Maintain accurate participant information and documentation in accordance with CCC and state requirements.
• Identify and appropriately **escalate** participant questions, barriers, concerns, safety issues, or incidents requiring clinical or supervisory review.
• Collaborate with participants, families, representatives, stakeholders, and internal teams to support effective program operations.
• Maintain confidentiality and comply with HIPAA, DSS requirements, and CCC policies and procedures.
• Perform other duties as assigned to support program operations.

Requirements

Education:

• Associate degree preferred; equivalent combination of education, training, and relevant experience may be considered.

Experience:

• Experience in customer service, human services, healthcare, aging services, disability services, social services, or a related field preferred.
• Strong interpersonal, verbal, and written communication skills.
• Ability to explain complex program requirements in a clear, supportive, and understandable manner.
• Strong organizational, problem-solving, follow-through, and documentation skills.
• Ability to manage multiple priorities and work both independently and collaboratively.
• Proficiency with Microsoft Office applications and electronic record systems.
• Knowledge of Community First Choice, Medicaid, self-directed services, or Home and Community-Based Services programs preferred.

Other: Reliable transportation, valid driver's license and current automobile insurance.

Work Environment and Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to perform these functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 35 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.

The company is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.