Role Overview

The Personal Care Connector (PCC) is vital in delivering high-quality, personalized service to Medicare members. Operating within a call center environment, the PCC supports daily functions of the Personal Service Program, Integrated Care Management, and Utilization Management initiatives. This role involves direct interaction with members, providers, and internal teams to ensure seamless access to care, resolution of issues, and promotion of health plan benefits and community resources.

Work Arrangement

• Remote -  Candidate must be located in the Philadelphia, PA area
• Schedule: Full-time (40 hours/week)
• Shift : 11:30 AM - 8:00 PM
• Training: 10 weeks, Monday–Friday, 8:30 AM – 5:00 PM
• Start Date: August 25, 2025

Key Responsibilities:

• Handle inbound and outbound calls from members and providers, ensuring timely and effective service aligned with performance metrics
• Identify care gaps and HEDIS-related health conditions, guiding members to appropriate care and resources
• Support clinical teams by managing transactions, resolving issues, and providing educational materials
• Document case notes accurately while engaging with members over the phone
• Educate members on plan benefits, services, and community support options
• Facilitate communication between members and provider offices to reduce barriers to care
• Meet or exceed call quality, documentation, compliance, and attendance performance standards

Education & Experience:

• High School Diploma or GED required
• 3 to 5 years in a call center environment with proven ability to manage high call volumes
• 2 to 4 years of experience with Medicare and Medicaid (preferred)
• Healthcare industry experience is a plus

Skills & Abilities

• Proficient in Microsoft Office Suite (Word, Excel, etc.) and capable of navigating multiple systems simultaneously
• Strong verbal and written communication skills
• Ability to multitask, think critically, and resolve issues efficiently
• Knowledge of health plan benefits and services is preferred
• Dependable with a strong attendance record

Your career starts now. We're looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we're 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 want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays, volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.