Healthcare Representative - Serene Health
San Diego, CA
About the Job
Empowering Wellness, Transforming Lives
Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, A Positive Choice, and PsycHealth, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.
As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.
Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members.
A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work!
Job Summary:
The Healthcare Representative is responsible for effectively communicating with health plan members to facilitate their onboarding into new health benefits and offering additional benefits. This role requires a strong understanding of various health plans, empathetic interaction with members, and adherence to healthcare regulations and organizational standards.
Responsibilities:
- Confirm eligibility status and onboard health plan members for additional benefits.
- Discuss new health plan benefits with members and their family/support persons.
- Navigate and utilize multiple health plans' EMR system.
- Treat members with empathy and respect, adhering to their religious and cultural preferences.
- Assist the care coordination team with developing health interventions and interacting with involved departments to expedite scheduling and completion of health care consult.
- Comply with organizational guidelines, healthcare laws, and regulations, including HIPAA by fostering nursing practices that adhere to the nursing division's standards of care.
- Maintains quality service by enforcing organization standards.
- Perform additional duties as needed.
Requirements / Qualifications:
- Bachelor's degree in Healthcare Administration or High school diploma / GED with healthcare clinical practice. (Required)
- Minimum 1 year of healthcare and/or sales and marketing experience. (Required)
- Bilingual in English and Spanish. (Preferred)
- Excellent communication, interpersonal, customer service and organizational skills.
- Proficient computer skills and experience with Microsoft Office.
- Maintain empathy and professionalism while contacting members and families.
Working Environment / Physical Requirements:
- Prolonged periods of sitting at an office desk on the computer.
- Lifting: Able to lift up to 15lbs.
Benefits
Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:
Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.
Short & Long-Term Disability Benefits: Protection when you need it most.
Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.
Flexible Spending Accounts: Manage your finances with flexibility.
Employee Assistance Program (EAP): Support when life throws challenges your way.
401(K): Building your financial future with us. Effective after 1 year of employment.
Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.
Paid Holidays: Quality time to enjoy celebrations.
Employee Referral Program: Share the opportunities and reap the rewards.
Company Discount Program: Enjoy savings on everyday expenses and memberships.
Equal Employment Opportunity
Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities.
Pre-Employment
Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.
