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 (Community Care of North Carolina) (plan) programs and offerings.   The Member Engagement Specialist interacts with members, providers, and other staff to initiate 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. This is primarily a remote position. Occasional in-person training and travel may be required.

Requirements

High School/GED.
Minimum of two years previous work experience, preferably in a health care setting
Healthcare experience and medical terminology knowledge highly preferred
Computer skills required including various office software and the internet; experience with MS Office software preferred
Strong Initiative
Performance metric driven and productivity mindset
Strong oral and written communication proficiency
Attention to detail
Organizational and Time Management Skills
Strong Interpersonal Skills
Critical Thinking Skills
Resourceful - Able to shift strategy or approach in response to the demands of a situation
Team-oriented
Adaptable - Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
Motivational Interviewing Skills
Knowledge of Care Management Principles
Ability to work independently and to use sound judgment when needed
Multi-tasking Abilities
Outgoing and energetic attitude
Respectful customer service skills
Ability to provide information in a manner that is culturally and linguistically appropriate
Knowledge of and experience working in member or clinical data systems

Nice To Haves

Prior telephonic call center experience desired
Bilingual preferred
Managed care experience a plus

Responsibilities

Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services.
Receive/retrieve and manage referrals from data reports; clinical care management team members, PCP (Primary Care Provider), 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 monthly productivity and role expectations.
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.
Collaborate with the Care Team to address barriers and create efficiency with processes.
Abide by department guidelines, company policies, and HIPAA regulations.
Perform all other duties as requested.
Attend departmental and corporate meetings.
Understand and uphold CCNC goals, objectives, and standards.