Member Services Specialist

 Job Description:

The Behavioral Health Member Services Specialists are responsible for managing PerformCare’s intake processes and serve as the first point of contact for Members accessing our services. PerformCare is a behavioral health managed care organization operating primarily in New Jersey and Pennsylvania.

We connect youth and families to essential mental health, intellectual/developmental disability (I/DD), and substance use services through public programs such as New Jersey’s Children’s System of Care (CSOC).

Key Responsibilities

• Answer incoming calls and provide information about PerformCare’s operations and services.
• Complete intake documentation for Members accurately and efficiently.
• Explain procedures for accessing behavioral health services.
• Coordinate with the Medical Assistance Transportation Program (MATP) to assist Members in securing transportation for scheduled appointments.
• Conduct bed searches for inpatient (IP) and substance abuse (SA) treatment requests.
• Address Member complaints by initiating the PerformCare Grievance and Complaint process.
• Explain Member rights upon request and provide additional resources, including the Member Handbook and provider lists within the Member’s geographic region.
• Enter requests and authorizations into the system accurately.

Schedule: 

• Monday – Friday
• Hours: 10:00AM – 6:00PM EST (with overtime potential)
• Weekend rotation required every two months
• First-shift availability during the 6-month training period is highly preferred
• Rotating Holidays required – Employees will be scheduled to work certain holidays on a rotating basis to ensure fair coverage among team members.

Education: Bachelor’s degree (BS or BA) from an accredited college or university required.

Preferred Skills:

• Experience in customer service, call center operations, behavioral health, managed care, human services, or data entry.
• One (1) to three (3) years of behavioral health experience preferred, with a minimum of one (1) year of experience in mental health, human services, or a related field.
• Strong verbal and written communication skills, with the ability to communicate effectively and sensitively with members, youth, families/caregivers, providers, and community partners.
• Demonstrated ability to deliver exceptional customer service while responding professionally and compassionately to inquiries.
• Strong organizational skills, attention to detail, and proficiency in data entry.
• Ability to work effectively in a fast-paced environment while maintaining accuracy, professionalism, and productivity.

• Proficiency with Windows-based computer applications and standard business software.

   

Our Comprehensive Benefits Package
Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.

Why Join Us: Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you are driven to make a difference, we want to hear from you.

About AmeriHealth Caritas
Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at http://www.amerihealthcaritas.com