HHIT Engagement Analyst

Blue Cross and Blue Shield of Massachusetts Inc.; Hingham (MA); On-site; USD 61,000 - 75,000; Full time

Benefits offered by this job

Paid time off

Health insurance (medical/dental/visi​

401(k)

Well-being benefits

Job summary

Blue Cross Blue Shield of Massachusetts is seeking a Member Engagement Specialist to connect with members, schedule appointments, and refer to care management to help achieve the best possible member health outcomes. The role emphasizes flexibility, collaboration, and proactive outreach to close gaps in care and improve NCQA and CMS STAR performance.

You will work within the HHIT in Clinical Quality and Compliance, coordinating with Care Management, Member and Provider Service, and Performance

Qualifications

• Excellent organization, communication, technical, customer service, and problem-solving skills.
• Knowledge of medical terminology, clinical data, and medical records.
• Ability to engage and obtain specific clinical information from members in a timely manner, to meet productivity while also serving our members’ needs.

Responsibilities

• Make outreach calls to members with gaps in care to assure adherence with HEDIS/STARs measures and contact provider offices to schedule appointments as needed.
• Escalate members to the HHIT Staff when clinical discussion is needed.
• Providing support of RN Provided Screening programs by scheduling and confirming patient appointments, documentation and faxing providers and other support functions as needed.
• Assist with non-clinical support needs from HHIT Staff including, but not limited to assisting members MyBlue registration, explaining gap related benefits and how to access benefits.
• Process faxed outreaches to providers by calling offices to confirm current patient status, obtaining fax number, sending fax and ensuring receipt of fax.
• Identify member barriers to obtaining care, promote appropriate resources, and make necessary referrals both internally and externally, to mitigate barriers.
• Ensure timely and clinically appropriate documentation in all required systems and meet daily productivity goals.
• Participate with Performance Measurement and Improvement in activities such as medical record reviews and provider outreaches.
• Provide onsite and virtual administrative support to the HHIT and Clinical Quality Team and for any associated improvement events (ex. Screening/Member events) as identified by Senior Manager.

Skills

Organization

Communication

Problem-solving

Education

Medical Assistant/Certified Pharmacy Technician

Senior/Medicare experience preferred

High school diploma or equivalent

Job description

Ready to help us transform healthcare? Bring your true colors to blue. The Role As a Member Engagement Specialist, you will be responsible for connecting with members, scheduling appointments, and referring to care management—all to achieve the best possible member health outcomes. You will leverage strong flexibility and collaboration skills, along with targeted approaches to connect with members in a timely manner to achieve the highest possible ratings from NCQA and CMS STARs. This position requires the ability to change priorities and processes frequently to support team initiatives, including medical chart reviews and performance measurement and improvement programs.

The Team As an integral part of the HEDIS HOS Intervention team (HHIT) within Clinical Quality and Compliance, you will coordinate and collaborate with teams and associates inside and outside of HMM, including Care Management, Member and Provider Service, and Performance Measurement and Improvement.

Key Responsibilities

• Make outreach calls to members with gaps in care to assure adherence with HEDIS/STARs measures and contact provider offices to schedule appointments as needed.
• Escalate members to the HHIT Staff when clinical discussion is needed.
• Providing support of RN Provided Screening programs by scheduling and confirming patient appointments, documentation and faxing providers and other support functions as needed.
• Assist with non-clinical support needs from HHIT Staff including, but not limited to assisting members MyBlue registration, explaining gap related benefits and how to access benefits.
• Process faxed outreaches to providers by calling offices to confirm current patient status, obtaining fax number, sending fax and ensuring receipt of fax.
• Identify member barriers to obtaining care, promote appropriate resources, and make necessary referrals both internally and externally, to mitigate barriers.
• Ensure timely and clinically appropriate documentation in all required systems and meet daily productivity goals.
• Participate with Performance Measurement and Improvement in activities such as medical record reviews and provider outreaches.
• Provide onsite and virtual administrative support to the HHIT and Clinical Quality Team and for any associated improvement events (ex. Screening/Member events) as identified by Senior Manager.

Key Qualifications

• Excellent organization, communication, technical, customer service, and problem-solving skills.
• Knowledge of medical terminology, clinical data, and medical records.
• Ability to engage and obtain specific clinical information from members in a timely manner, to meet productivity while also serving our members’ needs.

Education and Experience

Medical Assistant, Certified Pharmacy Technician, or equivalent health profession experience required Prior experience with seniors/Medicare members preferred Experience with clinical telephonic health coaching/call center preferred

Minimum Education Requirements

High school degree or equivalent required unless otherwise noted above

Location

Hingham

Time Type

Full time

Hourly Range

$29.45 - $35.99

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability. This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay "in the know" on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.

Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power, Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.

Our Commitment to You

We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.

Equal Employment Employer - veterans/disability

Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law. Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.