Description Your Role The Blue Shield of California Promise Health Plan Growth & Retention team is looking for an Enrollment and Retention Specialist who will educate and assist callers with the Medi-Cal enrollment process as it pertains Medi-Cal eligibility and plan enrollment to achieve new enrollment and member retention goals. In this role you will also assist members with the annual Medi-Cal redetermination process, advocate for callers with internal departments as well as County and State agencies and supports other growth projects. Adherence to all compliance requirements and maintaining appropriate documentation is essential to this role. The Blue Shield Promise Growth & Retention team reports to the Growth & Retention Supervisor. Responsibilities Your Work In this role, you will: Handle independently day-to-day growth and retention calls meeting all department performance standards Provide comprehensive eligibility and enrollment information to callers to identify best BSC product Work independently to facilitate member enrollment by working with Federal, State and Local County agencies escalating complex cases as needed Work with existing BSC members to help them stay in any BSC product Take the initiative to help callers with cases by conducting thorough follow-up assistance and utilizing and managing tracking systems Enter timely and precise documentation in all required systems adhering to department guidelines to ensure accurate reporting Interact with members via telephone to educate and conduct various call campaigns May assist with testing new processes/procedures and system enhancements Qualifications Your Knowledge and Experience Requires a high school diploma or GED Requires basic job knowledge of systems and procedures obtained through prior work experience or education Requires at least 3 years of experience Requires strong knowledge of the Medi-Cal program and Managed Care products/services Requires being Bilingual in Spanish Requires maintaining active compliance certifications #LI-AD3
Remote work option?
No
International candidates ok?
No
About Blue Shield of California
About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us! Our Values: Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short. Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives. Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals. Our Workplace Model: At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose – whether working in the office or through a hybrid approach – by providing clear expectations while respecting the diverse needs of our workforce. Two Ways of Working: Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions: o Member-facing and approved out-of-state roles remain remote. o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits. o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being. On-Site: Work from a business unit-approved office an average of four (4) or more days a week. Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day. Please click here for further physical requirement detail. Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
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