Quality Outreach & Member Engagement Specialist

Health Partners Plans, Inc.; Jefferson Center (PA); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Retirement plans

Tuition assistance

Disability coverage

Flexible spending accounts

Job summary

Health Partners Plans, Inc. seeks a Quality Outreach Unit Representative to engage members by outbound calls, support HEDIS/CAHPS measures, and enhance satisfaction. In a fast-paced call center, you will coordinate care, schedule appointments, address social determinants, and explain benefits to foster trust and retention.

The role emphasizes empathy, accurate documentation, and collaboration with HEDIS, care management, UM, enrollment, and member services to resolve member concerns effectively.

Qualifications

• High School Diploma or GED is required.
• Excellent telephone communication; bilingual in Spanish is desirable.
• Ability to work independently and as part of a team.
• PC literate and able to learn computer programs quickly.
• Exceptional customer service skills.
• Ability to work in a fast-paced call center environment.

Responsibilities

• Assist members via outbound calls, emphasizing 24/7 availability of HPP.
• Coordinate care by making outreach/reminder calls and scheduling multiple appointments.
• Encourage members to ask questions and express concerns about their care plan.
• Proactively assist with scheduling medical appointments.
• Identify and address social determinants of health and healthcare barriers.
• Educate callers about Health Partners Plans benefits to help retain members.
• Report trends impacting operations and member perception to management.
• Collaborate with internal departments to resolve member issues.
• Serve as frontline liaison, delivering care with empathy and professionalism.
• Maintain accurate call logs and documentation per requirements.
• Operate MIS and telephone systems following security protocols.
• Participate in staff meetings and training; report on trends affecting members.
• Perform other clerical and support tasks as assigned.

Skills

Telephone communication

Teamwork

Customer service

PC literacy

Fast-paced environment

Education

High School Diploma/GED

Tools

Phone systems

MIS systems

Job description

Health Partners Plans, Inc. seeks a Quality Outreach Unit Representative to engage members by outbound calls, support HEDIS/CAHPS measures, and enhance satisfaction. In a fast-paced call center, you will coordinate care, schedule appointments, address social determinants, and explain benefits to foster trust and retention.

The role emphasizes empathy, accurate documentation, and collaboration with HEDIS, care management, UM, enrollment, and member services to resolve member concerns effectively.