Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

This is for a 24/7/365 call center environment. This role is responsible for assessing individuals who are in crisis, providing in the moment brief support, and applying an appropriate intervention that meets the needs of the member while ensuring their safety. This position will be primarily remote and will be heavily based in technology including but not limited to, computer, web applications. Responsible for managing incoming calls, including triage, opening of cases and authorizing sessions. Supporting a Crisis Hotline for Beacon.

PLEASE REVIEW CLOSELY

If you do not reside in the following states- (Massachusetts, Rhode Island, New Hampshire, or Connecticut) you can only be eligible to work as contractor and this will NOT become a full time opportunity.

Primary duties may include, but are not limited to:

• Managing incoming calls or incoming post services claims work.
• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
• Obtains intake (demographic) information from caller.
• Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given.
• Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care.
• Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.
• Verifies benefits and/or eligibility information.
• May act as liaison between Medical Management and internal departments.
• Responds to telephone and written inquiries from clients, providers and in-house departments.
• Conducts clinical screening process.

Requirements:

• Requires HS diploma or equivalent; 2 years customer service experience in healthcare related setting and medical terminology training; or any combination of education and experience, which would provide an equivalent background.
• Master’s Degree or Bachelor's degree
• Crisis line or mental healthcare experience preferred
• Experience working on a text/chat platform completing assessments preferred
• Mental Health Assessment experience preferred
• De-escalation skills
• Motivational interviewing or similar skills
• Strong oral, written and interpersonal communication skills
• Problem-solving skills
• Customer service skills

Additional Details:

• Work from home/ remote, but must be located in Massachusetts.
• Mon-Fri 8a-4:30p (5 shifts)
• Mon-Fri 10a-6:30p (5 shifts)
• Please note this team operates 24/7, 365. Holiday coverage is a requirement of this role.

BCforward is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

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