Care Advocate (Bilingual Desired)

CHPW•Seattle, WA

11h•Onsite

About The Position

Responsible for supporting CHPW’s Medicaid, Cascade Select, and Dual Special Needs Plan (DSNP) members in navigating benefits and health care systems to promote optimal health and a positive experience with the Health Plan. This role conducts new member outreach such as welcome calls and Health Risk Assessments, as well as routine outreach to complete annual Health Risk Assessments, promote health screenings and engage members in the Care Management programs. Position may also serve as a primary contact for the Care Teams, receiving inbound calls from members to resolve members needs or triage to the appropriate CHPW staff or team. This role is an active participant of the Care Management Care Teams.

Requirements

Three (3) years in administrative, customer service, and/or patient services coordination (referrals, appointments, etc.) in a healthcare services field required
Ability to meet scheduled deadlines, manage time, organize, and prioritize work.
Effective verbal and written communication skills.
Ability to use Microsoft Office products such as Outlook, Word, and Excel.
Complete and successfully pass a criminal background check
Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency

Nice To Haves

One (1) year as a Medical Assistant or related field, preferred
Certified through an accredited medical assistant program, Allied Health education program, or other related certification, preferred
Working knowledge of medical terminology, electronic medical records, and healthcare process preferred.
Ability to speak Spanish preferred.

Responsibilities

Conduct telephonic outreach to identified members to complete Welcome Calls, member satisfaction surveys, and Health Risk Assessments (HRAs).
Educate members on accessing benefits, routine health screenings, program requirements (e.g., face-to-face visits, individualized care plans, interdisciplinary care team meetings), and how to engage with the Care Team.
Schedule and coordinate in-home assessments with Community Health Workers (CHWs), and telehealth or in-person provider visits with participating Community Health Centers (CHCs).
Conduct quarterly outreach to members previously unreachable (UTR).
Support members in closing care gaps and scheduling appointments with community or in-home providers.
Triage inbound calls from members, families, and caregivers; resolve issues or refer to appropriate staff.
Receive warm handoffs from internal teams (e.g., Sales, Pharmacy) for members needing HRAs or Care Team support.
Provide educational materials via phone, mail, or text as directed by the Care Team.
Participate in Care Team meetings and interdisciplinary team (ICT) conferences to support member care.
Refer members to internal programs by connecting them with the appropriate CHPW teams.
Access and manage medical records, including uploading documents and maintaining electronic health record (EHR) episodes.
Close EHR cases for members no longer enrolled and notify the assigned case manager.
Activate the Crisis Caller in Distress process to support members in crisis.
Prioritize and complete daily tasks independently and collaboratively.
Perform other duties as assigned.