Outreach Representative

Highmark Health; Delaware; On-site; USD 27,000 - 38,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

Job summary

Highmark Health seeks a liaison to support members, health plans, and regulators. The role involves telephonic outreach, scheduling appointments, and educating members on their rights and responsibilities.

You will assist with grievance and appeals, enroll members in Disease Management, and coordinate preventive health services with providers and community partners.

Qualifications

• High School diploma or GED required; Associate’s degree preferred.
• Experience in community outreach or customer service is required.
• Familiarity with healthcare and insurance and Medicaid/Medicare population is a plus.

Responsibilities

• Serve as liaison between members, health plan, and regulators via telephone.
• Provide appointment scheduling assistance and member education on rights and responsibilities.
• Assist members navigating grievance and appeals processes.
• Initiate outreach for preventive health initiatives and enroll members in Disease Management.
• Document contacts in systems for data collection and record keeping.
• Collaborate with staff, providers, and community agencies to coordinate services.

Skills

Proactive problem solving

Active listening

Time management

Multitasking

Empathy

Independent and team work

Customer interaction

Discretion

Diversity awareness

Education

High School Diploma/GED

Associate’s Degree (preferred)

Job description

Company :Highmark Inc.Job Description :JOB SUMMARYThis job is responsible for serving as a liaison between the member, the Health Plan, and the relevant state and/or federal regulators. The position conducts telephonic support to assess member needs, provide appointment scheduling assistance, and educating members of their rights and responsibilities. This position is also responsible for assisting members in navigating the grievance and appeals process and representing member interests internally and externally.ESSENTIAL RESPONSIBILITIESCommunicate effectively with staff, providers and members to accomplish business and member needsInitiate outreach efforts, primarily by telephone, related to targeted preventive health initiatives:Perform member education functions on the importance of targeted preventive health serviceRecruit, holistically assess and enroll members into Disease Management Programs as appropriateAssess opportunity for Care Management intervention and make appropriate referralContact members, providers and community agencies to coordinate access to preventive health servicesTracks all member and provider contacts in the appropriate computer systems for the purposes of data collection and record keepingParticipate in the development of outreach programs that are effective, measurable and innovative, with a special emphasis on reaching at risk members.Other duties as assigned or requested.EDUCATIONRequiredHigh School / GEDSubstitutionsNonePreferredAssociate’s DegreeEXPERIENCERequired1 year in Community Outreach or Customer ServicePreferredFamiliarity with healthcare and/or insuranceExperience working with the Medicaid and/or Medicare populationLICENSES or CERTIFICATIONSRequiredNonePreferredNoneSKILLSMust be proactive, self-directed, assertive and creative in problem solving and system planningStrong active listening skills with the ability to act sensitively toward diverse people and situations .Ability to successfully interact with external customers, peers, colleagues, and management teamDemonstrate effective time management skills and demonstrate an ability to prioritize and handle multiple tasks simultaneouslyMust demonstrate sound judgment and discretion when approaching problems and making decisionsThis position must be able to utilize sound and flexible productive work habits to set priorities, organize work and utilize time effectivelyMust be aware of issues members face related to healthcare including transportation, child care, lack of knowledge concerning preventive health, distrust of the system as well as other personal, social, financial barriersMust demonstrate patience and empathy when interacting with members and all internal/external customersThis job requires the ability to work independently and as a team memberLanguage (Other than English):NoneTravel Requirement:0% - 25%PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONSPosition TypeOffice-basedTeaches / trains others regularlyOccasionallyTravel regularly from the office to various work sites or from site-to-siteRarelyWorks primarily out-of-the office selling products/services (sales employees)NeverPhysical work site requiredYesLifting: up to 10 poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to 50 poundsNeverDisclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.Pay Range Minimum:$19.66Pay Range Maximum:$27.42Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.For accommodation requests, please contact HR Services Online at [e-mail] Consumer Privacy Act Employees, Contractors, and Applicants Notice