Member Engagement & Quality Improvement Specialist

CommunityCare, Inc.; Tulsa (OK); Sur place; USD 21 000 - 30 000; Plein temps

Résumé du poste

CommunityCare, Inc. is seeking a dedicated outreach-focused professional to perform outbound member calls and support plan development to close gaps in care. The role centers on quality program activities and may involve extended calls, coordination with clinicians, and collaboration on additional projects.

The position emphasizes strong communication, organizational skills, and experience with healthcare services, with potential involvement in various outreach channels and community resources.

Qualifications

• Knowledge of HMO plans, enrollment, benefits and claims.
• Experience interacting effectively with diverse individuals.
• Highly organized with strong attention to detail.
• Proficient in Microsoft Office applications.
• Excellent problem-solving skills.
• Bilingual abilities preferred.
• Strong oral and written communication skills.
• Health Care Sanctions background.

Responsabilités

• Contact members for intervention and help develop plans to close identified HEDIS gaps.
• Compile results for analysis and share opportunities for improvement with supervisor.
• Organize call lists and related activities for efficiency.
• Assist with development of call campaigns, scripts, and outreach (apps, text messaging).
• Collaborate on other outreach projects (mailings, web outreach, on-site events).

Connaissances

Knowledge of HMO plans

Interpersonal skills

Highly organized

Microsoft Office

Problem solving

Bilingual preferred

Oral and written communication

Health Care Sanctions background

Formation

High school diploma or equivalent

Bachelor's degree preferred

Elderly/geriatrics experience preferred

Face-to-face customer experience

3 years customer service experience

Healthcare/insurance/medical office experience preferred

Claims examining experience preferred

Cross-trained on multiple lines of business

Outils

Microsoft Office

Description du poste

CommunityCare, Inc. is seeking a dedicated outreach-focused professional to perform outbound member calls and support plan development to close gaps in care. The role centers on quality program activities and may involve extended calls, coordination with clinicians, and collaboration on additional projects.

The position emphasizes strong communication, organizational skills, and experience with healthcare services, with potential involvement in various outreach channels and community resources.