HHIT Engagement Analyst

Blue Cross Blue Shield of Massachusetts•Hingham, MA

1d•$29 - $36•Onsite

About The Position

As a Member Engagement Specialist, you will be responsible for connecting with members, scheduling appointments, and referring to care management—all to achieve the best possible member health outcomes. You will leverage strong flexibility and collaboration skills, along with targeted approaches to connect with members in a timely manner to achieve the highest possible ratings from NCQA and CMS STARs. This position requires the ability to change priorities and processes frequently to support team initiatives, including medical chart reviews and performance measurement and improvement programs. As an integral part of the HEDIS HOS Intervention team (HHIT) within Clinical Quality and Compliance, you will coordinate and collaborate with teams and associates inside and outside of HMM, including Care Management, Member and Provider Service, and Performance Measurement and Improvement.

Requirements

Excellent organization, communication, technical, customer service, and problem-solving skills.
Knowledge of medical terminology, clinical data, and medical records.
Ability to engage and obtain specific clinical information from members in a timely manner, to meet productivity while also serving our members’ needs.
Medical Assistant, Certified Pharmacy Technician, or equivalent health profession experience required.

Nice To Haves

Prior experience with seniors/Medicare members preferred.
Experience with clinical telephonic health coaching/call center preferred.

Responsibilities

Make outreach calls to members with gaps in care to assure adherence with HEDIS/STARs measures and contact provider offices to schedule appointments as needed.
Escalate members to the HHIT Staff when clinical discussion is needed.
Providing support of RN Provided Screening programs by scheduling and confirming patient appointments, documentation and faxing providers and other support functions as needed.
Assist with non-clinical support needs from HHIT Staff including, but not limited to assisting members MyBlue registration, explaining gap related benefits and how to access benefits.
Process faxed outreaches to providers by calling offices to confirm current patient status, obtaining fax number, sending fax and ensuring receipt of fax.
Identify member barriers to obtaining care, promote appropriate resources, and make necessary referrals both internally and externally, to mitigate barriers.
Ensure timely and clinically appropriate documentation in all required systems and meet daily productivity goals.
Participate with Performance Measurement and Improvement in activities such as medical record reviews and provider outreaches.
Provide onsite and virtual administrative support to the HHIT and Clinical Quality Team and for any associated improvement events (ex. Screening/Member events) as identified by Senior Manager.