About the position
As a Representative in Customer Service for Oncology/Cardiology II at Evolent Health, you will play a crucial role in ensuring client satisfaction by working directly with the Client Services department. Your primary responsibilities will include completing patient and provider notifications regarding medical treatment determinations, adhering to departmental policies, regulatory requirements, and client contractual agreements. This position offers the opportunity to contribute to a dedicated team focused on delivering exceptional service and improving health outcomes for patients. You will be part of a collaborative environment where you will support health plans, providers, and clinicians, and your performance will be recognized and rewarded by leadership. In this role, you will handle inbound calls from providers, health plans, and patients in a call center setting. You will issue referrals to specialists, conduct telephonic outreach to health plans and provider offices, and complete notifications both verbally and through written correspondence. Building rapport with clients through effective engagement strategies will be essential. You will also be responsible for accurately documenting information received from members and clients into Evolent's online clinical system. Additionally, clerical duties such as faxing, scanning documents, and preparing letters will be part of your daily tasks. You will support Utilization Management functions by performing activities that do not require clinical evaluation or interpretation, and you will participate in team meetings to ensure smooth operations within the Client Services staff. This position is designed for individuals who thrive in a fast-paced environment and are committed to providing high-quality customer service. You will have the satisfaction of being a key link in the healthcare process, contributing to better health outcomes for patients while working in a supportive and inclusive workplace.
Responsibilities
- Receive inbound calls in a Call Center environment from providers, health plans, and patients.
- Issue referrals to Specialists.
- Make telephonic outreach to health plans, provider offices, and patients.
- Complete notifications telephonically and generate letter notifications to inform of medical treatment determinations.
- Utilize engagement strategies to build rapport with clients.
- Accurately document information received from members, provider offices, and health plan clients into Evolent's online clinical system.
- Perform clerical duties such as faxing and scanning documents, creating shipping labels, and preparing letters and parcels using office machines.
- Support Utilization Management functions by performing activities that do not require evaluation or interpretation of clinical information.
- Assist in completing daily tasks by participating in meetings and working closely with the management team and Client Services staff.
- Perform other duties as assigned.
Requirements
- 1+ year call center experience.
- Strong attention to detail and organization.
- Strong listening skills.
- Ability to use positive language and exercise patience.
- Good interpersonal, oral, and written communication skills.
- Integrity and discretion to maintain confidentiality of members, employee, and physician data.
- Ability to work in a team environment.
- Willingness to learn new skills.
- Strong work ethic built on a foundation of proactivity and teamwork.
- Computer proficiency in Microsoft Office.
Nice-to-haves
- Oncology and/or Cardiology experience.
- Health care/pharmacy experience.
- Customer Service experience.
- Bilingual English and Spanish.
Benefits
- Comprehensive health insurance benefits
- Bonus component based on performance factors
