Job description

Position: Quality Outreach Coordinator

Location: Remote

Duration: 06+ Month

Description:

Receives incoming calls from members emanating from quality outreach initiatives such as mailings, emails, phone calls, etc.
Makes outgoing calls to educate members on the importance of closing gaps in care such as appropriate testing, periodical checkups, immunizations, counseling and provide health education materials.
Maintain accurate member records from outreaches such as incoming calls, successful outreaches, member issues, and member roadblocks.
Act as a liaison with providers, members and outside community resources by assisting with scheduling an appointment, warm transfers to member services, etc.
Assure understanding level of each member by providing clear and complete information in accordance with company guidelines.
Administer Rewards and Incentive programs for both Medicaid and Medicare members by sending out rewards, confirm member demographics, and educate members in regards to the R&I Program.
Refer members to a Clinical Quality nurse as necessary.

Education/Experience:
1. Requires an associate degree from an accredited college or university, preferably in healthcare field. In lieu of degree applicant must have 3 years of equivalent and relevant work experience.
2. Requires 2 years work experience in case management, community health, Medicaid, or health insurance environment.
3. Requires a minimum of 2 years’ experience working with members to close gaps in care.
4. Requires a minimum of 1-year managed care experience.

Additional licensing, certifications, registrations:
Knowledge:
1. Requires knowledge of the Managed Care or Health Insurance Industry.
2. Requires knowledge of medical terminology.
3. Requires knowledge of PC's and windows-based software applications.
4. Prefer knowledge of Medicaid and Medicare regulations.

Skills and Abilities:
1. Requires excellent verbal and written communication skills.
2. Requires excellent service quality skills.
3. Requires excellent organizational and interpersonal skills.
4. Requires good decision-making skills.
5.Requires good problem solving/conflict resolution skills.
6.Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint); Should be knowledgeable in the use of intranet and internet applications.

Job Type: Contract

Pay: $19.00 - $21.00 per hour

Schedule:

• 8 hour shift

Experience:

• Call center: 1 year (Preferred)
• Customer service: 1 year (Preferred)
• Medicare: 1 year (Preferred)
• medicaid: 1 year (Preferred)
• Health Insurance: 1 year (Preferred)

Work Location: Remote

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