Care Navigator at Spectraforce Technologies

Position Title: Care Navigator

Work Location: Remote - Texas

Assignment Duration: 6 months

Work Schedule: 9:30 AM to 6:00 PM (with overtime based on business needs)

Work Arrangement: Remote call center

Position Summary:

• Take calls all day in a remote call center.

• Assist and educate individuals or legally authorized representatives in the STAR Kids Medicaid program on LTSS benefits and services such as MDCP, PCS, DAHS, Respite (LTSS list not all inclusive), and DME requests.

• Remote call center, engagement via Teams.

Key Responsibilities:

• Handle inbound calls and assist STAR Kids members or representatives.

• Educate callers about LTSS programs and benefits.

• Use Microsoft Office Suite, Avaya, Zoom, and Skype for daily tasks.

• Document all calls using proper grammar and punctuation.

• Maintain excellent attendance and professional communication.

Qualification & Experience:

• Education/Certification: High School Diploma required.

  • Preferred but not required: BA in Social Work or Healthcare Management, LVN, CNA, CMA, RT, or Pharmacy Tech.

• Years of Experience: 4 years' experience in call center, Medicaid, and MCO insurance required.

• Must Haves: Good attendance, call center experience, and MCO insurance background.

• Nice to Haves: Service coordination or healthcare-related call center background.

• Disqualifiers: No call center experience.

• Performance Indicators: Consistent attendance, call quality, proper documentation, and active listening.

• Software Skills: Microsoft Office Suite, Avaya, Zoom, Skype
  
  

  Candidate Requirements
  Education/Certification	High Schook Diploma			Preferred BUT NOT Required: BA in Social Work or Healthcare Mgmt, LVN, CNA, CMA, RT, Pharmacy Tech
  Licensure	n/a			Preferred:
  Years of experience required Disqualifiers Best vs. average Performance indicators		Years Experience: 4 years experience, call center, Medicaid and worked with MCO Insurance. Must haves: good attendance, call center background; worked with MCO insurance Nice to haves: background in Service Coordination, and call center experience. Disqualifiers: no call center experience Performance indicators: Software Skills: Will be using various software on the job: Microsoft Office Suite, Avaya, Zoom, Skype
  Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection		1	1. Call Center Experience: Prior experience in a call center environment is essential. 2. Experience with Children/Youth: Must have worked with children or youth for at least 3 of the past 5 years. (This is contractual - if a candidate does not have at least 3 years of experience working with children or youth, an offer will not be extended.) 3. Strong Documentation Skills: Ability to document calls using complete sentences, proper punctuation, and correct grammar. 4. Excellent Listening Skills: Attentive and responsive listening is a key part of this role. 5. Call Handling Focus: The primary responsibility is managing incoming calls. Candidates must be comfortable wearing a headset for the entire shift and have a quiet, dedicated workspace. 6. Medicare/Medicaid Knowledge: Familiarity with Medicare and Medicaid programs is preferred. 7. Work Schedule: Must be available to work a consistent shift from 9:30 AM to 6:00 PM. 8. Critical Thinking Skills: Ability to assess caller needs quickly, make sound decisions to assist members and providers, escalate issues appropriately, adapt to unexpected situations.
  		2	Computer Knowledge - Avaya, Microsoft applications are key
  		3	Insurance, MCO background.