Job Details

Position Purpose: Care Engagement is responsible for supporting the organization's goals of obtaining health needs screenings, scheduling preventive service appointments and educating members on plan benefits and services. Provide members with educational materials and carry out strategies to increase health care adherence and reduce barriers to care.

Education/Experience: High School diploma or equivalent and 3+ years of sales experience in a call center or other high pressure sales environment, or experience in member, provider, customer service, or call center; or Bachelor degree in healthcare, business administration, or related field and 1+ years of sales experience in a call center or other high pressure sales situation, or experience in member, provider, customer service, or call center. Bilingual in Spanish and English preferred.

Make outbound or receive inbound calls from members to schedule doctor appointments, assist members that need to complete Health Needs Screenings or make payments to become eligible for enhanced benefits.
Influence members to take advantage of additional benefits available by educating members on enhanced services that are available and recommending preferred providers.
Educate members on utilization of Emergency Departments in non-emergent conditions and the impact to their benefits.
Identify and overcome barriers in order for members to complete needed health screenings, obtain needed services or make payments to secure enhanced benefits.
Review each member profile prior to outreach to identify areas of opportunity, which includes but is not limited to reviewing additional benefits available for members and identify opportunities for members to become eligible for additional benefits.
Participate in continuous quality improvement initiatives to ensure department and company goals are met and exceeded.
Review and analyze data for call reports to make adjustments as needed to call approach for members in order to obtain information.
Act as a secondary resource for the Member Services or Provider Services call centers.

EEO:

"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."

Story Behind the Need

• What is the purpose of this team?
• Describe the surrounding team (team culture, work environment, etc.) & key projects.
• Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?

We are a telephonic team reaching out to our most vulnerable Medicare members who remain non-compliant for their annual preventive screenings and preventive visit. (outbound calls, about 10 calls per hour) documenting assessment applications. Proficient in excel and word doc.

Outbound Member facing but may speak with providers for appointments
Typical Day in the Role

• Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
• What are performance expectations/metrics?
• What makes this role unique?

We expect our team to reach out to 10 members per hour. The role is designed to assist the members with scheduling an appointment with their provider and addressing all open care gaps. This role provides educational information, along with SDoH barriers support.

Weekly office hours for questions and monthly 1on1's with provided support via group chat. Resource folder available to utilize for questions. Candidate Requirements Education/Certification Required: High school Preferred: Licensure Required: N Preferred: Years of experience required: Requires 1 - 2 years of related experience (call center OUTBOUND). Proficient in excel and word doc. Complies with all policies and standards. Needs someone who can lead a conversation. Must be articulate verbally and written. On calls with members while documenting in multiple systems. Ability to educate members.

PLEASE READ - Disqualifiers: State if the previous roles were contract, over qualified (physicians/masters degree), NO claims data, short term position (please state if contract and if completed) , no pharmacy techs, inbound customer service

dditional qualities to look for: Medical terminology
Must be articulate verbally and written. On calls with members while documenting in multiple systems. Ability to educate members.

Position is outbound - LOOKING FOR OUTBOUND CALL CENTER HISTORY

• Top 3 must-have hard skills stack-ranked by importance

1 bility to fully engage with members in a conversational manner while providing support for needed medical care. 2 bility to work on multiple sites and with multiple screens while continuing to engage the member- no dead air. 3 Complete needed assessments to close HEDIS care gaps.