Medicare Outreach Customer Service Representative, MI - Remote - McLaren Careers - Full-time

Position Overview

McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is dedicated to helping people live healthier and more satisfying lives. As a Medicare Outreach Representative, you will play a key role in delivering quality primary care and engaging with diverse communities on products and programs that attract and retain membership. In this role, you represent innovative health plans such as McLaren Health Plan (Michigan) and MDwise (Indiana), and help foster a dynamic, collaborative environment.

Key Responsibilities

• Deliver, strategize, and improve quality with a focus on primary care.
• Educate and network with individuals from diverse backgrounds about Plan products and programs.
• Establish and maintain relationships to promote healthy lifestyles among members.
• Track and trend HEDIS or Medicare Stars rates.
• Manage member and provider contacts to ensure positive outcomes.
• Support the Customer Service department Medicare Stars Program.
• This position is fully remote.
• Equal Opportunity Employer of Minorities/Females/Disabled/Veterans.

Required Qualifications

• High School Diploma or equivalent educational certification.
• Two (2) years’ experience in a customer service-related position.

Preferred Qualifications

• Associate Degree in health care administration, communication, marketing, or a related field.
• One year of experience in a community-focused outreach position.
• NCQA experience specific to HEDIS measurement.
• In-depth understanding of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes, and DRGs.