Member Services Representative

If interested in this position email Lauren Swartz at [email protected] and click "apply". Job postings at this company open and close quickly so send Lauren an email ASAP.

For qualified candidates, Lauren will provide the company's career website to apply, and will follow up with her company contact on your behalf.

Job Description:

The Behavioral Health Member Services Specialists are responsible for managing PerformCare's intake processes and serve as the first point of contact for Members accessing our services. PerformCare is a behavioral health managed care organization operating primarily in New Jersey and Pennsylvania. We connect youth and families to essential mental health, intellectual/developmental disability (I/DD), and substance use services through public programs such as New Jersey's Children's System of Care (CSOC).

Key Responsibilities

• Answer incoming calls and provide information about PerformCare's operations and services.
• Complete intake documentation for Members accurately and efficiently.
• Explain procedures for accessing behavioral health services.
• Coordinate with the Medical Assistance Transportation Program (MATP) to assist Members in securing transportation for scheduled appointments.
• Conduct bed searches for inpatient (IP) and substance abuse (SA) treatment requests.
• Address Member complaints by initiating the PerformCare Grievance and Complaint process.
• Explain Member rights upon request and provide additional resources, including the Member Handbook and provider lists within the Member's geographic region.
• Enter requests and authorizations into the system accurately.

*Work Arrangement: * Remote Opportunity

Schedule:

• Monday -- Friday
• 2nd Shift: 12:00 PM -- 8:00 PM (with overtime potential)
• Weekend rotation required every two months
• First-shift availability during the 6-month training period is highly preferred
• Rotating Holidays required -- Employees will be scheduled to work certain holidays on a rotating basis to ensure fair coverage among team members.

Education & Experience

• Bachelor's degree (BS or BA) from an accredited college or university required.
• 1--3 years of behavioral health experience preferred.
• Strong written and verbal communication skills; ability to respond sensitively to Member inquiries preferred.
• Previous customer service and data entry experience desired, preferably in a call center environment.
• Minimum of one year of experience in mental health and/or human services required, or equivalent experience.
• Proficiency in Windows-based PC applications.

Comprehensive Benefits Package

• Flexible work solutions, including remote and hybrid options.
• Competitive pay and paid time off, including holidays and volunteer events.
• Health insurance coverage for you and your dependents starting Day 1.
• 401(k) retirement plan, tuition reimbursement, and more.

About AmeriHealth Caritas

At AmeriHealth Caritas, we are passionate about helping people access care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer associates the opportunity to impact millions of lives through our national footprint of products, services, and award-winning programs. Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We provide integrated managed care products, pharmacy benefit management, specialty pharmacy services, behavioral health services, and administrative support.

Discover more at:

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