Member Engagement Specialist

Community Care of North Carolina Inc•Cary, NC

1d•Remote

About The Position

The Member Engagement Specialist is responsible for telephonic outreach and screening of identified members based on plan stratification for care management with a call center approach. An experienced and energetic communicator, the engagement specialist is focused on deepening program participation as well as making members aware of CCNC (plan) programs and offerings. The Member Engagement Specialist interacts with members, providers and other staff to implement program interventions, document activities, and refer risk appropriate members to professional staff according to protocols. The candidate for this position must have a disposition towards good customer service, be assertive without being aggressive, and always maintain a professional demeanor. The Member Engagement Specialist may work remotely within regions to cover the needs across the state.

Requirements

High School/GED.
Prior telephonic call center experience desired.
Minimum of two years previous work experience, preferably in a health care setting.
Healthcare experience and medical terminology knowledge highly preferred.
Bilingual preferred

Nice To Haves

Managed care experience a plus

Responsibilities

Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services.
Receive and manage referrals from data reports; clinical care management team members, PCP, or other service providers for efficient screening and linking members with care management.
Complete and document member screenings tools and refer clinical needs to most appropriate clinical care management team member for assessment and follow up;
Schedule members for face-to-face or telephonic encounters for care management follow up.
Meet daily and monthly program productivity and engagement metrics.
Complete all assignments within expected timeframes;
Notify supervisor promptly of any issues with receiving or sending referrals, making timely care management assignments, or issues with carrying out any other duties assigned.
Abide by department guidelines, company policies, and HIPAA regulations.
Perform other duties that assist in keeping the operation organized and functional.
Attend departmental and corporate meetings.
Understand and uphold CCNC goals, objectives, and standards.