Health Program Representative II at Elevance Health

St. Louis, Missouri, United States

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

HS diploma or the equivalent and a minimum of 6 months experience; or any combination of education and experience which would provide an equivalent background

Responsibilities

Provides initial contact between distinct Care Management programs and specific identified members
Handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features
Gathers and records appropriate member information in accordance with policies and procedures via telephone
Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services
Records call details and utilizes call scripts as needed based on client requirements
Directs member inquiries to appropriate clinical staff
Initiates referrals and manages consults from clinicians for participants registered in Care Management
Gathers information from hospitals, health plans, physicians, patients, vendors and other referral sources
Contacts physician offices to obtain demographic information or related data as needed
Mentors less experienced Health Program Advocates

Skills

Care Management

Member Enrollment

Telephone Communication

Call Scripting

Referral Management

Data Gathering

Mentoring

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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