The Switchboard Operator is responsible for managing inbound contact center interactions via phone, email, and other channels, which includes answering calls, directing traffic, and contacting providers. Key duties also involve handling basic patient scheduling questions, verifying/cancelling appointments, and escalating clinical inquiries when necessary.

The pharmacy technician focuses on medication delivery and inventory management, handling basic patient and provider service responsibilities through communication and message retrieval. Responsibilities also include preparing and labeling medications, maintaining records, and participating in care activities that do not require pharmacist expertise.

The Care Management Coordinator utilizes critical thinking and judgment to collaborate on the case management process, facilitating appropriate healthcare outcomes by providing care coordination, support, and education to members. This involves conducting comprehensive evaluations of member needs, implementing assigned care plans, and consulting with multidisciplinary teams to overcome barriers and ensure quality of care.

The role involves handling inbound calls from providers regarding Credentialing Verification Organization (CVO)/Provider Enrollment, creating call records (CTN), and guiding providers through the GAMMIS system for information access and application status updates. Responsibilities also include applying general insurance and healthcare policies in compliance with regulations and escalating complex issues as needed.