Medical Management & Outreach Support Specialist
About The Position
The Medical Management & Outreach Support Specialist is the initial telephonic contact between the Arkansas Blue Cross Blue Shield Case Management (CM) team and identified program members. This role provides non-clinical support to Exchange Medical Management CM teams and serves as a program liaison for patients throughout service offerings, including admission through post-discharge care and outpatient referrals. The position works from home within Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota. Preference is given to current employees and candidates residing in Arkansas, Utah, Idaho, or North Dakota. The role is classified as a sedentary general office worker position. Work is normally performed in an office or remotely, with routine work-related travel within walking distance of the primary work assignment.
Requirements
- High school diploma or equivalent.
- At least one year of office and/or customer support experience interacting with customers by telephone, email, and/or in person.
- Interpersonal communication skills.
- Oral and written communication skills.
- Problem-solving skills.
- Facilitation skills.
- Attention to detail.
- Microsoft Office skills.
- Medical terminology.
Nice To Haves
- Previous experience in a role requiring an understanding of managed care or Medicaid/Medicare.
Responsibilities
- Assist with the case referral process.
- Assist with engagement and scheduling for complex cases.
- Attend and actively participate in meetings as required.
- Collaborate, as needed, with external community-based organizations to facilitate and coordinate care under the direction of an RN Case Manager.
- Collaborate with social workers and/or care managers to develop action plans.
- Facilitate communication among patients, families, colleagues, and community-based organizations as needed.
- Gather clinical information regarding cases and determine the appropriate area to refer or assign each case for case management.
- Maintain and update tracking databases.
- Perform other duties as assigned.
- Prepare reports and document clear, concise notes on all actions.
- Promote member engagement and high enrollment in case management to help members achieve health goals.
- Provide information about network providers or general program information when requested.
- Work to identify social determinants of health that affect patients’ health and general well-being.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Education Level
High school or GED
