Outreach Representative

Highmark Health • PA, Working at Home - Pennsylvania, PA

2d • $20 - $27 • Remote

About The Position

This job serves as a liaison between members, the Health Plan, and relevant state and/or federal regulators. The position provides telephonic support to assess member needs, assist with appointment scheduling, educate members about their rights and responsibilities, and help them navigate the grievance and appeals process. It also represents member interests internally and externally.

The role focuses on outreach related to targeted preventive health initiatives, including educating members about preventive services, enrolling appropriate members in Disease Management Programs, identifying opportunities for Care Management intervention, and coordinating access to preventive services. The position is full-time and work from home, with a schedule of 8:00 AM to 4:30 PM EST. Travel requirement is 0%–25%.

Requirements

• High school diploma or GED.
• At least 1 year of experience in community outreach or customer service.
• Proactive, self-directed, assertive, and creative problem-solving and system-planning skills.
• Strong active listening skills and the ability to act sensitively toward diverse people and situations.
• Ability to interact successfully with external customers, peers, colleagues, and management.
• Effective time management, prioritization, and ability to handle multiple tasks simultaneously.
• Sound judgment and discretion when approaching problems and making decisions.
• Ability to set priorities, organize work, and use time effectively and productively.
• Awareness of healthcare-related barriers members may face, including transportation, child care, lack of preventive-health knowledge, distrust of the system, and personal, social, or financial barriers.
• Patience and empathy when interacting with members and internal and external customers.
• Ability to work independently and as a team member.

Nice To Haves

• Associate’s degree.
• Familiarity with healthcare and/or insurance.
• Experience working with the Medicaid and/or Medicare population.

Responsibilities

• Communicate effectively with staff, providers, and members to address business and member needs.
• Initiate outreach, primarily by telephone, related to targeted preventive health initiatives.
• Educate members on the importance of targeted preventive health services.
• Recruit, holistically assess, and enroll members in Disease Management Programs as appropriate.
• Assess opportunities for Care Management intervention and make appropriate referrals.
• Contact members, providers, and community agencies to coordinate access to preventive health services.
• Track member and provider contacts in appropriate computer systems for data collection and record keeping.
• Participate in developing effective, measurable, and innovative outreach programs, with special emphasis on reaching at-risk members.
• Perform other duties as assigned or requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED