Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY:  

Under moderate supervision performs entry-level tasks including but not limited to monitoring incoming calls, preparing packets for members, monitoring outgoing mail and perform pre-screen calls for disease management program.  Direct services to CHC Members and their families for purposes of culturally appropriate health education, navigating healthcare systems, identifying available resource assistance.   Works closely with case management, DM programs and other initiatives of Health Services and CHC.

MINIMUM QUALIFICATIONS:   

  • Education/Specialized Training/Licensure: High School Diploma or GED. Bachelors Degree in Sociology, Social Work, or Psychology preferred.  
  • Work Experience (Years and Area):   Associates or higher degree with 1-year healthcare customer service experience; or 3 years of healthcare customer service experience in lieu of degree
  • Software Operated: Microsoft Office (Word, Excel, Outlook)

SPECIAL REQUIREMENTS:   

  • Communication Skills:
  • Above Average Verbal (Heavy Public Contract)
  • Bilingual Skills Required?   No Languages: Bilingual (English and Spanish) strongly preferred
  • Writing /Composing: Yes  (Correspondence  /  Reports)
  • Medical Terminology  P.C., MS Word , MS Excel
  • Work Schedule:   Flexible
  • Other Requirements: Microsoft Office Suite, filing, telephone skills, ability to work independently. Bilingual (English and Spanish) strongly preferred

RESPONSIBLE TO:
Supervisor/Manager

 

Application Instructions

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