Clinical Call Center Representative – TCM/CCM - Bilingual (English/ Spanish)

Nirvana Healthcare Management Services

West Orange (NJ)

In loco

USD 40.000 - 55.000

Tempo pieno

6 giorni fa

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Vantaggi offerti da questo lavoro

401(k)

401(k) matching

Dental insurance

Health insurance

Life insurance

Paid sick time

Paid time off

Vision insurance

Descrizione del lavoro

Nirvana Healthcare is seeking a bilingual, medically trained Call Center Representative based in New Jersey to support Transitional Care Management (TCM) and Chronic Care Management (CCM) initiatives. The role requires English/Spanish fluency and clinical knowledge to communicate effectively with patients and coordinate with the clinical team.

Responsibilities include inbound/outbound calls, post-discharge follow-up, CCM outreach, medical documentation in EMR, and escalation of urgent issues.

Competenze

Must be bilingual in English and Spanish.
Prior clinical or hands-on medical experience is required.
Experience with EMR/EHR systems preferred.
Strong communication and organizational skills are essential.

Mansioni

Conduct inbound and outbound patient calls related to TCM and CCM services.
Follow up with patients after hospital discharge to coordinate care and schedule follow-ups.
Outreach to patients enrolled in CCM programs.
Review patient-reported symptoms and escalate clinical issues as needed.
Assist patients with medication questions and document concerns for the clinical team.
Identify barriers to care and assist with transportation, appointment access, and medications.
Document all interactions accurately in the EMR system.
Coordinate with physicians, nurses, and care coordinators to ensure continuity of care.
Provide patient education and reinforce care plans under clinical supervision.
Maintain patient confidentiality and HIPAA compliance.
Meet call volume and documentation accuracy expectations.

Conoscenze

Bilingual EN/ES

Clinical experience

Medical terminology

Communication skills

Time management

Independent worker

Documentation accuracy

Escalation ability

Formazione

MA/LPN/FM G background

Healthcare certification

Strumenti

EMR/EHR systems

Descrizione del lavoro

Position Summary

Nirvana Healthcare is seeking a bilingual, medically trained Call Center Representative to assist with patient outreach and coordination for our Transitional Care Management (TCM) and Chronic Care Management (CCM) programs.

The ideal candidate will have prior clinical experience, a strong understanding of medical terminology, and the ability to communicate effectively with patients regarding their healthcare needs. This position requires fluency in both English and Spanish and the ability to provide compassionate, professional patient support while working closely with our clinical team.

Key Responsibilities

Conduct inbound and outbound patient calls related to TCM and CCM services.
Contact patients following hospital discharge to assist with transitional care coordination and scheduling follow-up appointments.
Perform routine outreach to patients enrolled in Chronic Care Management programs.
Review patient-reported symptoms, medical concerns, and healthcare needs, escalating clinical issues to the appropriate licensed medical professional.
Assist patients with medication-related questions by documenting concerns and referring them to the clinical team when necessary.
Identify barriers to care, including transportation, appointment availability, and medication access, and assist with appropriate coordination.
Document all patient interactions accurately and promptly in the Electronic Medical Record (EMR) system.
Communicate with physicians, nurses, care coordinators, and other healthcare professionals to ensure continuity of care.
Provide patient education and reinforce established care plans under the direction of the clinical team.
Maintain patient confidentiality and comply with HIPAA regulations and company policies.
Meet departmental expectations for call volume, documentation accuracy, and patient follow‑up.

Qualifications and Requirements

Bilingual in English and Spanish (required).
Previous clinical or hands‑on medical experience (required).
Background as a Medical Assistant (MA), Licensed Practical Nurse (LPN), Foreign Medical Graduate (FMG), or similar medically trained professional preferred.
Experience working in a medical practice, outpatient clinic, hospital, or healthcare call center.
Knowledge of medical terminology, common chronic conditions, medications, and basic clinical procedures.
Familiarity with Transitional Care Management (TCM) and Chronic Care Management (CCM) programs preferred.
Experience using Electronic Medical Records (EMR/EHR) systems.
Strong communication, organizational, and multitasking skills.
Ability to recognize patient concerns that require clinical escalation.
Strong attention to detail and ability to document patient interactions accurately.
Ability to work independently and collaboratively in a fast‑paced healthcare environment.

Preferred Experience

Previous experience conducting patient outreach, follow‑up calls, or care coordination.
Familiarity with chronic conditions such as diabetes, hypertension, cardiovascular disease, and COPD.
Experience working with Medicare patients and care management programs.
Knowledge of hospital discharge procedures and post‑discharge patient follow‑up.

Skills and Competencies

Excellent bilingual verbal communication skills.
Strong patient service and interpersonal skills.
Basic clinical knowledge and understanding of patient care needs.
Ability to handle sensitive patient information with professionalism and discretion.
Effective time management and follow‑through.
Ability to recognize and appropriately escalated urgent patient concerns.

Position Expectations

The Bilingual Clinical Call Center Representative is expected to maintain consistent communication with patients, support timely TCM and CCM outreach, ensure accurate documentation, and assist the clinical team in promoting continuity of care and positive patient outcomes.

All clinical activities must remain within the employee's training, credentials, authorized responsibilities, and established clinical protocols.

Benefits: