Member Support Specialist I

PacificSourceBend, OR
$32,312 - $51,699Hybrid

About The Position

Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths. Work as an integral part of the case management team to serve as a resource to members and community providers/partners. Work telephonically and in-person to support members with complex psycho-social issues which create barriers to adherence with medical regimens and achievement of optimal health outcomes. Assist with program development, team processes, as well as build effective member, provider and community partner relationships.

Requirements

  • Requires a minimum of one year of experience in community service or healthcare agencies providing coordination of services.
  • High school diploma or equivalent required.
  • Medical terminology.
  • Proficient in Microsoft Office, including Word, Excel, PowerPoint, Medical management software (e.g CaseTrakker Dynamo).
  • Excellent verbal and written communication skills and ability to work independently as well as to work effectively on a team.
  • Good working knowledge of how to access community resources and healthcare system.
  • Stoop and bend.
  • Sit and/or stand for extended periods of time while performing core job functions.
  • Repetitive motions to include typing, sorting and filing.
  • Light lifting and carrying of files and business materials.
  • Ability to read and comprehend both written and spoken English.
  • Communicate clearly and effectively.

Nice To Haves

  • Call center experience preferred.

Responsibilities

  • Utilize motivational interviewing and patient-engagement techniques to support members in achieving optimal health outcomes by effectively utilizing their benefits.
  • Effectively handle incoming department telephone calls and emails.
  • Identify member needs and refer to the appropriate internal resources.
  • Screen case management referral requests from multiple internal and external sources.
  • Assist case management team to facilitate the case management process.
  • Create events in Medical Management Platform.
  • Assist with quality measures.
  • Assist with member-focused meetings and complete associated administrative tasks as indicated.
  • Assist with other administrative duties as appropriate, including meeting minutes.
  • Ensure compliance with applicable state and federal regulations and guidelines in day-to-day activities.
  • Ensure accurate and timely electronic and documentation within multiple software programs.
  • Manage electronic mailing lists, group phone queue and outgoing mailings.
  • Participate in team, department, company, and community-related projects/committees as requested.
  • Meets department and company performance and attendance expectations.
  • Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  • Perform other duties as assigned.

Benefits

  • Our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence.
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