Member Outreach Representative

Prominence Health; McAllen (TX); On-site; USD 38,000 - 58,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Challenging and rewarding work env.

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision and药

401(K) with company match and stock"

SoFi Student Loan Refinancing Program

Career development opportunities with

Job summary

Prominence Health is seeking a Member Outreach Representative to contact members by phone and educate them on health insurance offerings, programs, and services. You will respond to inquiries, support member health assessments, and identify quality gaps for improvement initiatives in collaboration with leadership.

This role may require non-business hours to reach members. Candidates should have strong communication skills, healthcare or managed care experience, and a customer-focused mindset in

Qualifications

• High School diploma or equivalent.
• 3+ years' experience in making outbound calls to members and/or patients preferred.
• 3+years’ customer service experience in a managed care, medical office or health care related field preferred.
• Understanding of health plan departments and functional areas for problem resolution.
• Comfortable collecting and tracking performance metrics and managing team to certain performance expectations.
• Ability to effectively communicate in English, both verbally and in writing.
• Positive attitude is a must.
• Proficient in Microsoft Office skills.
• Enjoys working in both individual and team settings.
• Problem solver – enjoys problem-solving.
• Self-starter, resourceful and able to execute projects in a fluid and fast-paced environment.
• Good communication and relationship skills.
• Strong analytical skills.
• Attention to detail.
• High level of energy.

Responsibilities

• The Member Outreach Representative serves as a call agent reaching out to members to promote quality and wellness programs.
• Contact Prominence Health Plan members by phone to inform and educate them on the health insurance offerings, products or services.
• Respond to inquiries and assist with quality improvement and member health assessments.
• Identify quality insufficiencies and consult with department and company leaders on quality improvement initiatives and outcomes.
• Work non-business hours to better reach members via telephone.

Skills

Outbound calls

Customer service

English communication

Microsoft Office

Education

High School diploma or equivalent

Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary

The Member Outreach Representative serves as a call agent reaching out to members to promote quality and wellness programs. The primary function of the outreach agent will be contacting Prominence Health Plan members by phone to inform and educate them on the health insurance offerings, products or services, as well as respond to inquiries and assist with quality improvement and member health assessments. The Member Outreach Representative will identify quality insufficiencies and will consult with the department and company’s leaders on quality improvement initiatives and outcomes. Will work non-business hours in order to better reach members via telephone.

Benefit Highlights

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications and Requirements

• High School diploma or equivalent.
• 3+ years' experience in making outbound calls to members and/or patients preffered.
• 3+years’ customer service experience in a managed care, medical office or health care related field preferred.
• Understanding of health plan departments and functional areas for problem resolution
• Comfortable collecting and tracking performance metrics and managing team to certain performance expectations
• Ability to effectively communicate in English, both verbally and in writing.
• Positive attitude is a must.
• Proficient in Microsoft Office skills.
• Enjoys working in both individual and team settings
• Problem solver – enjoys problem-solving
• Self-starter, resourceful and able to execute projects in a fluid and fast-paced environment
• Good communication and relationship skills
• Strong analytical skills
• Attention to detail
• High level of energy

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.