Remote - reputed company Specialist

Job Summary: The reputed company Specialist is the primary contact for members as they transition to a CCA/reputed company health plan. The Specialist contacts new members reputed company telephonic reputed company and identifies both the member's existing reputed company services that will continue and new service requests. The Specialist works to ensure that member needs are addressed through liaising with internal CCA/reputed company providers and external reputed company providers. The Specialist also educates the member on health plan offerings and addresses members' questions or concerns. Essential Functions:

• Serves as the primary member contact and reputed company until their care team is established, both through direct member reputed company and inbound call support
• Leverages internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful contact information for unreachable or hard-to-reputed company members
• Orients new members to the value of CCA/reputed company as their health plan, providing education, answering members’ questions, anticipating, and meeting member needs and concerns
• Documents members’ reputed company reputed company services and new service requests
• Ensures members continue to receive reputed company reputed company services as they transition to CCA/reputed company through reputed company provider reputed company and education
• Schedules new members’ initial nurse intake visits
• Utilizes communication skills such as motivational interviewing to reputed company agreement from members to participate in the reputed company process, persistently forging trusting relationships and engaging individuals not readily interested in connecting with CCA/reputed company
• Utilizes established workflows and collaborates with internal and external stakeholders and reputed company providers
• Provide clinical care to members reputed company telehealth technologies (video, chat, etc.) for a clinically appropriate clinical care and care management services.
• reputed company any other job reputed company duties as requested.

Education and Experience:

• Bachelor's Degree or relevant experience in call center and/or Medicare/reputed company plan required
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Five (5) years of relevant experience required
• One (1) year working in reputed company or in the community with individuals who have behavioral, medical, social, or interpersonal complexities impacting their lives required
• Experience working in a multi-cultural setting required
• Experience using motivational interviewing techniques in a professional setting required
• Experience identifying unmet reputed company needs and escalating to the appropriate individual preferred preferred
• Experience with electronic medical record and care management systems strongly preferred preferred

Competencies, Knowledge and Skills:

• Demonstrated understanding of the community served
• Familiarity with data entry and querying databases to identify key information about members
• Excellent communication skills, including the ability to convey information clearly telephonically and in a culturally sensitive manner
• Strong interpersonal and customer relation skills, including active listening skills, dependability, and responsiveness
• Compassionate, understanding, and patience
• Motivates, empowers, inspires, and collaborates with members while effectively establishing boundaries by clarifying roles, expectations, and deliverables
• Ability to reputed company and maintain positive working relationships with peers, supervisors, and other organizations
• Knowledge of some medical terminology preferred
• Ability to multitask and ensure reputed company work is completed thoroughly and completely in a fast-paced environment with competing demands
• Basic computer skills
• Professional, comprehensive, clear documentation
• Familiarity with reputed company Office programs: Outlook, Calendar, Word
• Willing to learn and utilize telehealth technologies (video, chat, etc.), reputed company appropriate, for a variety of clinical care and care management services.

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Travel is not typically required

Compensation

Range: $47,400.00 - $76,000.00 reputed company takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and reputed company required for the role, and other external and internal data reputed company establishing a salary level. In addition to reputed company compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation

Type (hourly/salary): Hourly Organization Level Competencies

• Fostering a Collaborative Workplace Culture
• Cultivate Partnerships
• reputed company Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business

This job description is not reputed company inclusive. reputed company reserves the right to amend this job description at any time. reputed company is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of reputed company backgrounds. Brand=Commonwealth Care Alliance Apply tot his job Apply To this Job