Member Care & Outreach Specialist

Unilogic Healthcare Management, LLC.; Los Angeles (CA); On-site; USD 40,000 - 52,000; Full time

Job summary

Unilogic Healthcare Management, LLC is seeking a Member Care Representative to work closely with enrollees and ensure completion of quality programs. You will perform 30/60/90-day evaluations, conduct outreach campaigns, and coordinate with providers to guarantee required care, while meeting daily outbound call goals and documenting progress in Cozeva and related systems.

Candidates should have strong customer service experience, knowledge of Medi-Cal/Medicare plans is a plus, and be proficient

Qualifications

• High school diploma or GED; related healthcare or managed care experience preferred.
• Two years of customer service experience required.
• Knowledge of Medi-Cal, Commercial or Medicare plans is a plus.
• Healthcare outreach experience is desirable.

Responsibilities

• Conduct special program outreach campaigns to assigned members and ensure program completion.
• Perform 30/60/90-day evaluations to monitor duties and probation status.
• Maintain 85% compliance rate or 4-star equivalent on Star Measures.
• Assist members in obtaining required care and coordinate with providers.
• Coordinate with field team to complete home visits and meet campaign goals.
• Meet daily outbound call targets; address inbound calls promptly.
• Utilize Office 365, Five9, Cozeva, Outlook and Excel as required.
• Document progress in Cozeva or related systems and report weekly.
• Collaborate with QI and Member Care Advocates on campaigns.
• Escalate physician and member concerns professionally and resolve issues.
• Perform data sweeps to collect medical records and upload results.

Skills

Customer service

Outreach campaigns

Data entry

Communication skills

Time management

Education

High school diploma or GED

Medical Assistance Certificate (preferred)

Phlebotomy License (preferred)

Tools

Cozeva

Five9

Office Suite

Excel

Job description

Unilogic Healthcare Management, LLC is seeking a Member Care Representative to work closely with enrollees and ensure completion of quality programs. You will perform 30/60/90-day evaluations, conduct outreach campaigns, and coordinate with providers to guarantee required care, while meeting daily outbound call goals and documenting progress in Cozeva and related systems.

Candidates should have strong customer service experience, knowledge of Medi-Cal/Medicare plans is a plus, and be proficient