Medical Management & Outreach Support Specialist

Arkansas Blue Cross Blue Shield; EUA; Remoto; USD 22.000 - 29.000; Tempo integral

Resumo da vaga

Arkansas Blue Cross Blue Shield is seeking a Medical Management & Outreach Support Specialist to serve as the initial telephonic contact for program members. The role provides non-clinical support across CM teams, guiding members from admission to post-discharge care and outpatient referrals.

The position requires a high school diploma and at least one year in office/customer support, with preference for experience in managed care or Medicaid/Medicare contexts.

Qualificações

• Education: High school diploma or equivalent.
• Experience: Minimum one year in office or customer support, preferably in managed care or Medicaid/Medicare contexts.

Responsabilidades

• Assists with case referral process.
• Assists with complex cases member engagement and scheduling.
• Attends and actively participates in meetings as required.
• Collaborates with external community-based organizations to coordinate care under RN supervision.
• Develops action plans with care managers.
• Facilitates communication among patients, families, colleagues, and community organizations.
• Gathers clinical information to determine appropriate referrals.
• Maintains and updates tracking databases.
• Performs other duties as assigned.
• Prepares reports and documents with clear notes on actions.
• Promotes engagement and enrollment for case management to support health goals.

Conhecimentos

Interpersonal communication

Oral and written communication

Problem-solving

Facilitation

Attention to detail

Microsoft Office

Medical terminology

Formação

High school diploma or equivalent

Descrição da vaga

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here.

Job Summary

The Medical Management & Outreach Support Specialist will serve as the initial point of telephonic contact between Arkansas Blue Cross Blue Shield CM team and current identified program members for program engagement. This role is responsible for providing non-clinical support to the Exchange Medical Management CM teams as a program liaison responsible for patients throughout the duration of service offerings, including admission to post-discharge care and/or outpatient referrals.

Requirements

EDUCATION

• High school diploma or equivalent.

EXPERIENCE

• Minimum one (1) year office and/or customer support experience interacting with customers via telephone, e-mail, and/or in-person.
• Previous experience in a role requiring an understanding of managed care or Medicaid/Medicare preferred.

ESSENTIAL SKILLS & ABILITIES

• Interpersonal communication
• Oral and written communication
• Problem-solving
• Facilitation skills
• Attention to detail
• Microsoft Office
• Medical terminology

LOCATION

Work from home within Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota. Preference will be given to current employees and candidates who reside in Arkansas, Utah, Idaho, and North Dakota.

Skills

• Action Plan Development
• Analytical Thinking
• Communication
• Detail-Oriented
• Facilitation
• Health Outreach
• Interpersonal Communication
• Medical Terminology
• Problem Solving

Responsibilities

• Assists with case referral process.
• Assists with complex cases member engagement and scheduling
• Attends and actively participates in meetings as required.
• Collaborates, as needed, with external community-based organizations to facilitate and coordinate care under the direction of an RN Case Manager.
• Collaborates with social workers and/or care manager to develop action plan.
• Facilitates communication between all parties (patients, families, colleagues, and community-based organizations) as needed.
• Gathers clinical information regarding case and determines appropriate area to refer or assign case (case management ).
• Maintains and updates tracking databases.
• Performs other duties as assigned.
• Prepares reports and documents clear and concise notes on all actions.
• Promotes engagement and high enrollment with members for case management to help achieve health goals.
• Provides information regarding network providers or general program information when requested.
• Works to identify social determinants of health impacting patient’s health and general well-being.

Certifications

Hiring Range

$16.27 - $21.13

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.