Member Support Specialist

Position Overview: Work as an integral part of the case management team to serve as a resource to members and community providers/partners. Work telephonically and in-person to support members with complex psycho-social issues which create barriers to adherence with medical regimens and achievement of optimal health outcomes.  Assist with program development, team processes, as well as build effective member, provider and community partner relationships.

Essential Responsibilities:

• Utilize motivational interviewing and patient-engagement techniques to support members in achieving optimal health outcomes by effectively utilizing their benefits. 
• Effectively handle incoming department telephone calls and emails.
• Identify member needs and refer to the appropriate internal resources.
• Screen case management referral requests from multiple internal and external sources.
• Assist case management team to facilitate the case management process.
• Create events in Medical Management Platform.
• Assist with quality measures.
• Assist with member-focused meetings and complete associated administrative tasks as indicated.
• Assist with other administrative duties as appropriate, including meeting minutes.
• Ensure compliance with applicable state and federal regulations and guidelines in day-to-day activities.
• Ensure accurate and timely electronic and documentation within multiple software programs.

Supporting Responsibilities:

• Manage electronic mailing lists, group phone queue and outgoing mailings.
• Participate in team, department, company, and community-related projects/committees as requested.
• Meets department and company performance and attendance expectations.
• Follow the company privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

Work Experience: Requires a minimum of one year of experience in community service or healthcare agencies providing coordination of services. Call center experience preferred.

Education, Certificates, Licenses: High school diploma required. 

Knowledge: Medical terminology. Proficient in Microsoft Office, including Word, Excel, PowerPoint, Medical management software (e.g  CaseTrakker Dynamo). Excellent verbal and written communication skills and ability to work independently as well as to work effectively on a team. Good working knowledge of how to access community resources and healthcare system.

Competencies

• Building Customer Loyalty
• Building Strategic Work Relationships
• Contributing to Team Success
• Planning and Organizing
• Continuous Improvement
• Adaptability
• Building Trust
• Work Standards

 To be considered, please submit your resume for review.