Coordinates member outreach to ensure effective use of health plan benefits, ensure member receipt of important clinical services, and to improve member health outcomes within the Medicaid or Medicare population. Responds to member inquiries in person, via telephone, and in writing. Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory and contractual requirements including outreach to members who are noncompliant in the designated outreach services. Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.
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Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED