Member Engagement Specialist – Healthcare Quality

bcbsma; Hingham (MA); On-site; USD 40,000 - 50,000; Full time

Benefits offered by this job

Paid time off

Medical/dental/vision insurance

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 improve health outcomes. You will support HHIT and Clinical Quality initiatives, coordinate care with providers, and help members access benefits and MyBlue services.

The role requires strong organization, communication, and knowledge of medical terminology, with preferred Medicare experience and telephonic coaching capabilities.

Qualifications

• Medical Assistant or equivalent health profession experience required.
• High school degree or equivalent required.
• Preferred experience with seniors/Medicare or clinical telephonic health coaching/call center is a plus.

Responsibilities

• Make outreach calls to members with gaps in care to ensure adherence to HEDIS/STARs.
• Schedule appointments and coordinate with care providers.
• Support RN Provided Screening programs by scheduling and confirming patient appointments.
• Assist members with MyBlue registration and explain gap-related benefits.
• Process provider outreaches by calling offices to confirm current patient status and send required information.
• Identify member barriers to obtaining care and refer to internal/external resources.
• Ensure timely and accurate documentation in required systems and participate in improvement activities.
• Provide onsite and virtual administrative support to HHIT and Clinical Quality teams.

Skills

Organization

Communication

Problem solving

Customer service

Medical terminology

Education

Medical Assistant or equivalent health profession experience

High school diploma or equivalent

Job description

Blue Cross Blue Shield of Massachusetts is seeking a Member Engagement Specialist to connect with members, schedule appointments, and refer to care management to improve health outcomes. You will support HHIT and Clinical Quality initiatives, coordinate care with providers, and help members access benefits and MyBlue services.

The role requires strong organization, communication, and knowledge of medical terminology, with preferred Medicare experience and telephonic coaching capabilities.