Member Engagement Representative

AllCare Management Services•Grants Pass, OR

10d•Onsite

About The Position

The Member Engagement Representative is responsible for conducting proactive outreach to health plan members through phone calls and written communication. This role focuses on educating members about the importance of preventive care, supporting chronic condition management, and promoting overall wellness. The position also involves accurate documentation, collaboration with internal teams, and contributing to care coordination efforts.

Requirements

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
High school diploma or general education degree (GED) required.
One to three months’ experience working in customer service, member engagement, care coordination, community health, or a related field is preferred.
Valid Oregon Driver’s License and vehicle insurance.
Familiarity with the healthcare industry
Knowledge of and compliance with HIPAA regulations
Computer skills, including the Microsoft Office Suite (Outlook, Word, , and Excel)
Knowledge of customer service and service recovery best practices
Knowledge of phone customer service best practices
Excellent organization and time-management skills
Demonstrates accountability and inspires trust and confidence from others
Communicates effectively and professionally with team members and customers
Collaborates within a multidisciplinary, diverse team to provide professional service
Maintains an attentive, empathetic, and professional demeanor
Adapts to change, learns quickly, and works well with ambiguity
Manages time effectively, prioritizes tasks, and meets competing deadlines
Takes initiative and applies sound judgment in completing tasks
Self-resolves most conflicts or misunderstandings with minimal supervision
Provides respectful and understanding service in a multicultural environment
Maintains the high degree of professionalism and confidentiality
Works with high initiative, energy, and effectiveness in a fast-paced environment
Interacts positively with customers to resolve problems in a pleasant and professional manner
Uses creativity and resourcefulness to solve new problems
Copes and self-manages during stressful situations
Creates a pleasant experience for all customers by being personable and attentive
Meets timelines for goals safely and with a high level of quality
Ability to read a limited number of two- and three-syllable words and to recognize similarities and differences between words and between series of numbers. Ability to print and speak simple sentences.
Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
Has the minimal skills necessary to operate a computer. Can log on to a computer system, navigate in windows, perform simple tasks within applications and enter information into a database.
Ability to apply common sense understanding to carry out simple one- or two-step instructions. Ability to work with standardized situations with only occasional or no variables.
The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The noise level in the work environment is usually moderate.
The employee must be able to work onsite (for all scheduled shifts, occasionally, frequently, as needed).
The employee must be able to travel locally, as needed.
Because of exposure to patient records of all types, the highest standard of patient confidentiality and privacy as established by business policy and HIPAA requirements must be maintained.

Responsibilities

Conducts outbound phone calls and sends written communications to educate members on preventive health services and the importance of follow-up care.
Accurately documents all member interactions using EZ Cap and Essette systems in accordance with organizational standards.
Collaborates with internal staff to retrieve documentation and perform basic data analysis to support member care coordination and outreach initiatives.
Collaborates and assists with departmental and interdepartmental staff to coordinate care for members with questions about benefits or health concerns.
Participates in community health activities, outreach efforts, and special projects.
Adheres to all HIPAA privacy and security regulations to protect member information.
Communicates health information clearly and effectively while actively listening to member needs.
Tracks and documents multiple outreach projects with accuracy and attention to detail.
Monitors and assesses member needs during phone calls and follows up on any healthcare concerns.
Applies logic and reasoning to identify opportunities for program improvement and outreach expansion.
Maintains a flexible schedule to support varying work locations, meeting sites, and educational events.
Supports data collection and reporting efforts to evaluate outreach effectiveness and member engagement outcomes.
Maintains punctual, regular and predictable attendance.
Works collaboratively in a team environment with a spirit of cooperation.
Respectfully takes direction from leadership.
Meets all required training including those listed in Relias Learning Module System (LMS).
Performs other duties as assigned.