Elderplan

Responds to member and provider inquires and requests concerning benefits, claims and complaints within a call center environment to ensure high quality customer service. Receives calls from members and providers, responds to complaints and grievances and records all call details. Receives requests for adjustments on claim issues and disenrollment.

Reporting to the Supervisor of Care Management, this role involves providing case management to members, addressing their medical, social, psychological, physical, and spiritual needs. Responsibilities include developing, implementing, and monitoring care plans in collaboration with PCPs, caregivers, and team members to meet member needs in managed care.