Position Purpose: The Contact Center Buddy is a single point of contact for members for all things related to the health plan. A Contact Center Buddy assists members in navigating the health plan and executes activities such as; find quality doctors, schedule appointments, communicate with internal and external partners (case managers, providers, claims etc.), resolve member issues.
- Provide inbound and outbound communication and develop a relationship with members
- Assist with wellness campaigns to ensure successful outcomes
- Educate members on wellness programs to better manage a health condition or disease
- Conduct member interactions through multiple channels such as telephone, email, mail
- Complete any necessary paperwork and facilitate the processing of prior authorization requests, case management referrals, bill problems, pharmacy issues etc.
- Obtain all medical information needed for determination and forward to clinical reviewers when criteria is not met
- Coordinate authorizations after the initial 7-day authorization has expired
- Complete outbound member retention calls
- Additional department support and tasks, as assigned
Education / Experience / Other Requirements
Years of Experience: