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Member Outreach Representative (2)


Responsible for engaging members to schedule appointments for preventive care and chronic care services. Representatives will also be responsible for logging calls and creating reports as needed to show scheduling progress.

Duties and Responsibilities

  • Use member gap reports to call members and encourage him/her to schedule preventive care and chronic care services to meet HEDIS/STARs requirements
  • Work with specialists, PCPs and ancillary providers to assist with scheduling members for above services
  • Contact members to encourage completion of annual member satisfaction surveys
  • Log outbound and inbound calls into sPHERICAL member outreach module
  • Create reports on a weekly and monthly schedule to show scheduling progress
  • Collaborate on innovative programs to more fully engage members and improve participation in these areas
  • Assist HEDIS/STARs quality coordinators on special projects
  • Collaborate on scripting for member outreach phone calls
  • Additional projects in the Quality Management department as required

Minimum Job Requirements:

  • High School graduate or GED equivalent
  • One year experience working in a call center environment; health care environment preferred
  • Ability to work varying shifts if requested to assist in increasing patient outreach

Knowledge, Skills and Abilities Required:

  • Effective verbal and written communication skills and effective interpersonal skills.
  • Ability to work well in a busy department
  • Able to stay focused on the telephone even with noise and other distractions
  • Bilingual (Spanish and English) preferred
  • Minimum or higher proficiency level with Microsoft Office Programs; primarily Word and Excel 2013 or higher
  • EZ-CAP® knowledge a plus.

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Job title: Member Outreach Representative (2)

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