Inland Empire Health Plan

Under the supervision of the Eligibility Continuity Manager, the Eligibility Continuity Specialist will provide full Redetermination of Eligibility (RE) application assistance to IEHP Members to help maintain their Medi-Cal eligibility.. Strive to live and practice IEHP’s Mission, Vision, and Values (MVV) every day, and strongly commit to advance the organization’s strategic plan.. Conduct outbound calls to IEHP Members to help them understand the Medi-Cal Redetermination of Eligibility (RE) process and complete the RE application upon Members’ request.. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.. IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

eligibility specialist

*What you can expect! * Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an *authentic experience!* Under the supervision of the Eligibility Continuity Manager, the Eligibility Continuity Specialist will provide full Redetermination of Eligibility (RE) application assistance to IEHP Members to help maintain their Medi-Cal eligibility. Upon Member’s requests, the Eligibility Continuity Specialist will help complete the RE application, document any reported contact changes in the online Medi-Cal Eligibility portal, help prepare and submit documentations required for eligibility maintenance, and other assigned Eligibility-related duties, in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships. *Key Responsibilities* 1. Strive to live and practice IEHP’s Mission, Vision, and Values (MVV) every day, and strongly commit to advance the organization’s strategic plan. 2. Conduct outbound calls to IEHP Members to help them understand the Medi-Cal Redetermination of Eligibility (RE) process and complete the RE application upon Members’ request. 3. Help Members prepare and submit any documentation required for the purpose of eligibility maintenance. 4. Develop a thorough understanding of the Medi-Cal eligibility process and resources offered by the state, county, and within IEHP, including BenefitsCal.com and reporting tools. 5. Provide best customer services that reflects our MVV to IEHP Members. 6. Proactively identify opportunities for improvements, including frictionless processes. 7. Document call results in a Customer Relationship Management (CRM) database. 8. Document and submit information using an online portal. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. *Perks* IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. * Competitive salary. * Hybrid schedule. * CalPERS retirement. * State of the art fitness center on-site. * Medical Insurance with Dental and Vision. * Life, short-term, and long-term disability options * Career advancement opportunities and professional development. * Wellness programs that promote a healthy work-life balance. * Flexible Spending Account – Health Care/Childcare * CalPERS retirement * 457(b) option with a contribution match * Paid life insurance for employees * Pet care insurance *Education & Experience* * Two (2) or more years of relevant Medicaid Eligibility experience. * Professional phone etiquette with experience in a call center atmosphere. * Experience in the performance-based environment. * High School diploma or GED required. *Key Qualifications* * Must have a valid California Driver's License. * Knowledge of Medicaid (Medi-Cal) eligibility required. * Knowledge of customer services phone etiquette required. Job Type: Full-time Pay: $49,878.40 - $63,585.60 per year Benefits: * Dental insurance * Employee assistance program * Employee discount * Flexible spending account * Health insurance * Health savings account * Life insurance * Paid time off * Parental leave * Professional development assistance * Retirement plan * Tuition reimbursement * Vision insurance Schedule: * 8 hour shift * Monday to Friday Experience: * Customer service: 1 year (Preferred) * Managed Care: 1 year (Preferred) Language: * Mandarin (Required) Ability to Commute: * Rancho Cucamonga, CA 91730 (Preferred) Ability to Relocate: * Rancho Cucamonga, CA 91730: Relocate before starting work (Required) Work Location: Hybrid remote in Rancho Cucamonga, CA 91730

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