Remote Medical Management & Outreach Specialist

Arkansas Blue Cross Blue Shield; Bismarck (ND); Remote; USD 22,000 - 29,000; Full time

Job summary

Arkansas Blue Cross Blue Shield is seeking a remote Medical Management & Outreach Support Specialist to serve as the initial telephonic contact for program engagement and to provide non-clinical support to the Exchange Medical Management CM teams as a program liaison throughout service offerings, including admission to post-discharge care and outpatient referrals.

The role requires a high school diploma and at least one year of office/customer support experience, with preferred experience in

Qualifications

• High school diploma or equivalent.
• Minimum one year office/customer support experience.
• 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

Arkansas Blue Cross Blue Shield is seeking a remote Medical Management & Outreach Support Specialist to serve as the initial telephonic contact for program engagement and to provide non-clinical support to the Exchange Medical Management CM teams as a program liaison throughout service offerings, including admission to post-discharge care and outpatient referrals.

The role requires a high school diploma and at least one year of office/customer support experience, with preferred experience in