Wellness Advocate - Community Health Choice
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
The Wellness Advocate is responsible for handling non-clinical outbound calls to our Members. The Wellness Advocate will educate our Members on healthcare options and preventative screening services available to them. The Wellness Advocate is also responsible for helping our Members locate Providers, assist with scheduling appointments, education on their benefits and medical checkup needs, and connecting them to Community resources (when appropriate) while maintaining confidentiality per HIPAA guidelines.
Education/Specialized Training/Licensure: High School Graduate or equivalency required and some College preferred.
Work Experience (Years and Area): Two (2) years of experience in a customer service setting with high volume point of service contact. Individual should possess extensive knowledge of health insurance programs such as Medicaid, CHIP and Marketplace products and/or sales preferred.
Software Operated: Microsoft Office (Word, Excel, Outlook)
1. Communication Skills:
2. Other Skills: