CSR Healthcare Plan Navigator
Actalent
Job Title: Remote Care Navigator
Must be located in Texas
Job Description
We are seeking a dedicated Care Navigator to join our team! Candidates will assist in developing personalized care plans and providing support to healthcare plan members. This remote position will consist of taking inbound calls to assist and educate Medicaid members on benefits and Services such as PCP Changes, ID Cards and Coordinate transportation and other services.
Responsibilities
+ Develop or contribute to the development of personalized care plans and ongoing service plans.
+ Identify providers, specialists, and community resources needed for care.
+ Coordinate between the member, family/caregivers, and the care provider team to ensure timely access to identified care or services.
+ Monitor progress towards care plan goals and member status, collaborating with healthcare providers for plan revisions as needed.
+ Collect, document, and maintain all member information and care management activities to ensure compliance with regulatory requirements.
Essential Skills
+ Experience with managed care organizations (MCO).
+ Strong member service and customer support skills.
+ Proficiency in data entry and medical terminology.
+ Experience working in a call center environment.
+ Ability to work with aging, blind, and disabled populations.
+ Experience working with people with disabilities and vulnerable populations with chronic or complex conditions.
Additional Skills & Qualifications
+ High School Diploma or GED.
+ Minimum two years of experience working with managed care organizations (MCO).
+ Four years of combined work experience.
+ Bilingual in Spanish and English is highly preferred.
Pay and Benefits
The pay range for this position is $20.00 - $25.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision• Critical Illness, Accident, and Hospital• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available• Life Insurance (Voluntary Life & AD&D for the employee and dependents)• Short and long-term disability• Health Spending Account (HSA)• Transportation benefits• Employee Assistance Program• Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on May 29, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.
Confirm your E-mail: Send Email
All Jobs from Actalent