Member Outreach Representative

Summary

Assists with making outbound calls to members to provide assistance with scheduling preventive health and chronic care services.

Duties and Responsibilities:

• Makes outbound calls to members to provide assistance in obtaining services (eg, provide reminders, make appointments, arrange transportation, etc.) to improve member health outcomes and close HEDIS/STARs gaps.
• Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.
• Conducts HEDIS provider chart request calls and mailings.
• Handles HEDIS overreading responsibilities when requested.
• Assists with posting medical records for HEDIS chase.
• May maintain member incentive programs to support HEDIS initiatives.
• Maintains records in sPHERICAL database to track member compliance and responses.
• Records and documents all member and provider outreach activity.
• Performs other duties as required.

Minimum Job Requirements:

• High school graduate or GED equivalent
• Minimum of one year experience in a call center environment; health plan or medical group call center experience preferred.

Skills and Abilities:

• Effective verbal and written communication skills 
• Good interpersonal skills
• Ability to multitask in a busy department
• Excellent organizational skills
• Able to stay focused on the telephone despite noise and other distractions
• Microsoft Office 365 skilled (proficiency in Excel a plus)
• EZ-CAP® knowledge a plus

Salary Range:

• $19 – $21 hourly