Remote Medical Management & Outreach Liaison

Arkansas Blue Cross and Blue Shield; Arkansas; Hybrid; USD 22,000 - 29,000; Full time

Job summary

The Medical Management & Outreach Support Specialist will serve as the initial point of telephonic contact between Arkansas Blue Cross Blue Shield CM team and current identified program members for program engagement.

This role is responsible for providing non-clinical support to the Exchange Medical Management CM teams as a program liaison responsible for patients throughout the duration of service offerings, including admission to post-discharge care and/or outpatient referrals.

Qualifications

• Education High school diploma or equivalent.
• Experience Minimum one (1) year office and/or customer support experience interacting with customers via telephone, e-mail, and/or in-person.
• Previous experience in a role requiring an understanding of managed care or Medicaid/Medicare preferred.

Responsibilities

• Assists with case referral process.
• Assists with complex cases member engagement and scheduling
• Attends and actively participates in meetings as required.
• Collaborates, as needed, with external community-based organizations to facilitate and coordinate care under the direction of an RN Case Manager.
• Collaborates with social workers and/or care manager to develop action plan.
• Facilitates communication between all parties (patients, families, colleagues, and community-based organizations) as needed.
• Gathers clinical information regarding case and determines appropriate area to refer or assign case (case management ).
• Maintains and updates tracking databases.
• Performs other duties as assigned.
• Prepares reports and documents clear and concise notes on all actions.
• Promotes engagement and high enrollment with members for case management to help achieve health goals.
• Provides information regarding network providers or general program information when requested.
• Works to identify social determinants of health impacting patient’s health and general well-being.

Skills

Action Plan Development

Analytical Thinking

Communication

Detail-Oriented

Facilitation

Health Outreach

Interpersonal Communication

Medical Terminology

Problem Solving

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

The Medical Management & Outreach Support Specialist will serve as the initial point of telephonic contact between Arkansas Blue Cross Blue Shield CM team and current identified program members for program engagement.

This role is responsible for providing non-clinical support to the Exchange Medical Management CM teams as a program liaison responsible for patients throughout the duration of service offerings, including admission to post-discharge care and/or outpatient referrals.