Outreach Representative

Highmark; United States; On-site; USD 27,000 - 38,000; Full time

Job summary

Highmark Inc. seeks a Community Outreach Specialist to act as a liaison among members, the Health Plan, and relevant state and/or federal regulators.

The role provides telephonic support to assess member needs, assists with appointment scheduling, and educates members on their rights and responsibilities. The position supports navigating the grievance and appeals process, advocating for member interests, and coordinating with internal teams to enroll eligible individuals in disease management

Qualifications

• Experience in outreach or customer service preferred.
• Familiarity with healthcare and/or insurance.
• Experience working with Medicaid and/or Medicare populations preferred.

Responsibilities

• Communicate effectively with staff, providers and members to accomplish business and member needs.
• Initiate outreach by telephone related to preventive health initiatives and enroll members in Disease Management Programs as appropriate.
• Assess opportunity for Care Management intervention and make referrals.
• Contact members and providers to coordinate access to preventive health services.

Skills

Proactive problem-solving

Active listening

Time management

Judgment & discretion

Prioritization

Healthcare-awareness

Patience & empathy

Independent & teamwork

Education

High School / GED

Associate’s Degree

Job description

JOB SUMMARY

This 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.

Company

Highmark Inc.

ESSENTIAL RESPONSIBILITIES

• Communicate effectively with staff, providers and members to accomplish business and member needs
• Initiate outreach efforts, primarily by telephone, related to targeted preventive health initiatives
  • Perform member education functions on the importance of targeted preventive health service
  • Recruit, holistically assess and enroll members into Disease Management Programs as appropriate
  • Assess opportunity for Care Management intervention and make appropriate referral
  • Contact members, providers and community agencies to coordinate access to preventive health services
  • Tracks all member and provider contacts in the appropriate computer systems for the purposes of data collection and record keeping
• Participate 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.

EDUCATION

Required

• High School / GED

Substitutions

• None

Preferred

• Associate’s Degree

EXPERIENCE

Required

• 1 year in Community Outreach or Customer Service

Preferred

• Familiarity with healthcare and/or insurance
• Experience working with the Medicaid and/or Medicare population

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Must be proactive, self-directed, assertive and creative in problem solving and system planning
• Strong 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 team
• Demonstrate effective time management skills and demonstrate an ability to prioritize and handle multiple tasks simultaneously
• Must demonstrate sound judgment and discretion when approaching problems and making decisions
• This position must be able to utilize sound and flexible productive work habits to set priorities, organize work and utilize time effectively
• Must 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 barriers
• Must demonstrate patience and empathy when interacting with members and all internal/external customers
• Must demonstrate the ability to work independently and as a team member

Language (Other Than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type: Office-based

Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting up to 10 pounds
Constantly
Lifting 10 to 25 pounds
Occasionally
Lifting 25 to 50 pounds
Never

Disclaimer

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. This job requires employees to 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.

Base Pay

Base 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.

Discrimination Statement

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.

Accessibility Statement

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.

Accommodation Requests

For accommodation requests, please contact HR Services Online at [e-mail]

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Pay Range Minimum

$19.66

Pay Range Maximum

$27.42