Job description

Position Summary/Position

Under the supervision of the Eligibility Continuity Manager, the Eligibility Continuity Specialist will provide full Redetermination of Eligibility (RE) application assistance to IEHP Members to help maintain their Medi-Cal eligibility. Upon Member’s requests, the Eligibility Continuity Specialist will help complete the RE application, document any reported contact changes in the online Medi-Cal Eligibility portal, help prepare and submit documentations required for eligibility maintenance, and other assigned Eligibility-related duties.

This is a Bilingual (English/Chinese-Mandarin) position. The Team Member in this role must take a language proficiency assessment and must receive a passing score. Major Functions (Duties and Responsibilities)

1. Strive to live and practice IEHP’s Mission, Vision and Values (MVV) every day, and strongly commit to advance the organization’s strategic plan.
2. Conduct outbound calls to IEHP Members to help them understand the Medi-Cal Redetermination of Eligibility (RE) process and complete the RE application upon Members’ request.
3. Help Members prepare and submit any documentation required for the purpose of eligibility maintenance.
4. Develop a thorough understanding of the Medi-Cal eligibility process and resources offered by the state, county, and within IEHP, including BenefitsCal.com and reporting tools.
5. Provide best customer services that reflects our MVV to IEHP Members.
6. Proactively identify opportunities for improvements, including frictionless processes.
7. Document call results in a Customer Relationship Management (CRM) database.
8. Document and submit information using an online portal. Supervisory Responsibilities Leading: Self Experience Qualifications

Bilingual (English/Chinese-Mandarin) - written and verbal skills required.
Two (2) or more years of relevant Medicaid Eligibility experience. Professional phone etiquette with experience in a call center atmosphere. Experience in the performance-based environment. Preferred Experience

Experience in a health plan or County Medi-Cal office preferred. Education Qualifications

High School diploma or GED required. Preferred Education

Bachelor’s degree in a related field from an accredited institution preferred. Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement

Knowledge of Medicaid (Medi-Cal) eligibility required. Knowledge of customer services phone etiquette required. Skills Requirement

Skilled in providing best customer experience in phone calls. Maintain the professionalism when experiencing difficult calls. Able to have clear verbal communications and written documentation. Abilities Requirement

Maintain the confidentiality of the Members. Handle all Members’ request professionally in a high-volume call environment. Commitment to Team Culture

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions

General office or virtual office environment; using computer keyboard and screens; travel within California and other states if needed.

Position is eligible for telecommuting/remote work model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership. Work Model Location Telecommute Physical Requirements Keyboarding: Traditional - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Sitting - CONSTANTLY Lighting - CONSTANTLY Indoors - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY
A reasonable salary expectation is between $48,110.40 - $59,425.60 , based upon experience and internal equity.

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 7,000 and a team of more than 2,500 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.

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