Accountabilities:

• Engage members through inbound and outbound calls to encourage participation in care management programs and provide a positive, professional experience.
• Complete required non-clinical assessments and questionnaires to identify health risks, care needs, and opportunities for clinical follow-up.
• Help members schedule healthcare appointments and connect with appropriate care, benefits, and community resources.
• Identify barriers to preventive screenings, healthcare services, and benefits, and support members in addressing gaps in care.
• Explain and assist members with accessing benefits and resources that support their health and overall well-being.
• Navigate multiple applications and systems to accurately document, update, and maintain member information.
• Listen carefully to member needs, ask appropriate follow-up questions, and resolve issues within established policies and guidelines.
• Maintain required productivity, quality, service, and documentation standards in a high-volume call center environment.
• Stay current with departmental procedures, training, tools, and changing healthcare priorities.
• Work independently while managing time effectively, escalating questions when clarification or additional support is required.
• Maintain professionalism, compassion, confidentiality, and sound judgment when handling sensitive health-related information.
• Adapt to evolving member needs, operational priorities, and business processes while supporting team objectives.

Requirements

• Fluency in both English and Spanish, including the ability to successfully complete required language proficiency assessments in both languages.
• At least 1 year of experience managing high-volume inbound and outbound calls, preferably in a customer service, healthcare, insurance, or related environment.
• Demonstrated experience meeting documented productivity, quality, or service performance metrics.
• Experience navigating multiple applications, platforms, and programs while accurately documenting and updating customer or member information.
• Proficiency with Microsoft Word, Excel, Teams, and Outlook for communication, documentation, information tracking, and daily administrative tasks.
• Strong verbal and written communication skills, with the ability to interact professionally and empathetically with diverse populations.
• Excellent listening, problem-solving, organization, and time-management skills, with the ability to manage competing priorities independently.
• A compassionate and service-oriented approach, combined with integrity, accountability, flexibility, and sound judgment.
• Ability to work a scheduled 8-hour shift, including a 1-hour lunch, between 11:00 AM and 8:00 PM EST.
• Ability to work effectively in a fully remote environment with a dedicated workspace free from ongoing interruptions and suitable for protecting confidential member information.
• Reliable home internet service with a minimum 25 Mbps download and 10 Mbps upload speed.
• High school diploma or equivalent is preferred based on the role's operational requirements.
• Ability to accommodate occasional travel for training or meetings, despite the position being remote.
• Willingness to complete required training and meet attendance expectations, including full attendance during the initial two-week training period.
• Ability to accommodate occasional extended hours or mandatory overtime, including evenings or weekends, when business needs require it.

Benefits

• Annual salary range: $32,000–$41,800, with actual compensation varying based on location, skills, experience, education, certifications, and other job-related factors.
• Fully remote work opportunity for candidates who reside in Puerto Rico.
• Medical, dental, and vision coverage.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays.
• Paid parental and caregiver leave.
• Short-term and long-term disability coverage.
• Life insurance.
• Additional programs and resources designed to support whole-person well-being and informed healthcare decisions.
• Structured training and development to help you succeed in the role.
• Opportunity to directly support members while contributing to improved access to healthcare resources and services.
• Occasional travel to company offices may be required for training or meetings.
• Scheduled workweek of 40 hours, with the assigned shift generally running from 11:00 AM to 8:00 PM Eastern Time.
• Initial training is scheduled for approximately two weeks, generally from 9:00 AM to 5:30 PM Eastern Time, with attendance required throughout the training period.
• The position may include occasional extended hours, including evenings and weekends, based on business needs.