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Health Plan Member Services Counselor
Health Plan Member Services CounselorContra Costa County • Martinez, CA
Health Plan Member Services Counselor

Health Plan Member Services Counselor

Contra Costa County • Martinez, CA
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The Position

Bargaining Unit : Local 856 - Health Services Unit

CLOSING DATE : Open Until Filled

  • RE-ANNOUNCEMENT

Why Join Contra Costa Health?

The Contra Costa Health Services Department is recruiting for four (4) qualified candidates interested in the Health Plan Member Services Counselor positions assigned to the Contra Costa Health Plan (CCHP) located in Martinez, CA. Bilingual candidates, especially those fluent in Spanish and Mandarin, are strongly encouraged to apply.

The Health Plan Member Services Counselor will be responsible for assisting Health Plan members find solutions to issues, helping members understand the scope of available benefits and how to access healthcare delivery services, assisting members in choosing primary care providers, and educating members on the proper use of the Health Plan.

We are looking for someone who :

  • Is an excellent listener .
  • Is able to focus on the member’s needs and present the best solution.
  • Is patient with members who are upset and are able to de-escalate situations .
  • Is able to communicate effectively verbally and in writing.
  • Is able to positively adapt to changes within the unit.

    • What you will typically be responsible for :

  • Educating members on benefits and exclusions.
  • Processing requests for Medi-Cal emergency disenrollment by following guidelines.
  • Processing member interpreter request.
  • Identifying and conducting intake for complaints, grievances, appeals.
  • Engaging the community in planning processes.

    • A few reasons you might love this job :

  • The unit you will work in is a semi fast paced environment.
  • Build rapport with members and assist them with their inquiries.
  • Will acquire experience working in a Managed Care setting.

    • A few challenges you might face in this job :

  • Communicating with upset members.
  • Some phone calls may become stressful due to the needs of the member.
  • Handling and resolving member issues in a timely manner.

    • Competencies Required :

  • Professional & Technical Expertise : Applying technical subject matter to the job
  • Using Technology : Working with electronic hardware and software applications
  • Action & Results Focused (Taking Initiative) : Initiating tasks and focusing on accomplishment
  • Adaptability : Responding positively to change and modifying behavior as the situation requires
  • Attention to Detail : Focusing on the details of work content, work steps, and final work products
  • Handling Stress : Maintaining emotional stability and self-control under pressure, challenge, or adversity
  • Professional Integrity & Ethics : Displaying honesty, adherence to principles, and personal accountability
  • Informing : Proactively obtaining and sharing information
  • Listening : Fully comprehending spoken communication
  • Writing : Communicating effectively in writing
  • Customer Focus : Attending to the needs and expectations of customers
  • Professional Impact : Presenting self as a positive representative of the organization
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