Outreach Specialist

Elevance Health•Walnut Creek, CA

22h•Hybrid

About The Position

The Outreach Specialist will serve as the initial and main point of Field contact between the Company and current and potential members. This is a field-based role requiring associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. Candidates must reside in San Francisco, Santa Clara, or Sacramento (lower region) counties in California. The role involves responding to inquiries, providing timely and accurate resolution of issues related to benefits, policies, and services, and supporting State Sponsored Programs through community events and collaborations. The specialist will also support member access to care via home visits, report processing, and material distribution, and conduct new member orientations. Key expectations include providing superior quality outcomes and professional service, understanding the cultural and linguistic needs of the Medicaid and SCHIP population, and possessing knowledge of health and social services in the assigned region. Associates are expected to multi-task, maintain focus in a fast-paced environment, demonstrate strong communication skills, attention to detail, critical thinking, problem-solving, empathy, and proficiency with digital tools. The position has a structured work schedule with potential for occasional overtime or flexibility.

Requirements

HS Diploma or equivalent
Minimum of 1 year of customer service experience, or any combination of education and experience that would provide an equivalent background
Ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers
Ability to work from the office as necessary
Reside in one of these California counties: San Francisco, Santa Clara, or Sacramento (lower region)
Become vaccinated against COVID-19 and Influenza (for certain patient/member-facing roles)

Nice To Haves

Understanding of the basic principles of managed care and the concepts of publicly financed health insurance such as Medicaid and SCHIP programs
Community Health Worker Certification

Responsibilities

Responds to telephone, written, and in-person inquiries and initiates steps to assist regarding issues relating to content or interpretation of benefits, policies and procedures.
Provides timely and accurate resolution of inquiries and issues regarding benefits, services and policies.
Supports and promotes State Sponsored Programs through participation in community events.
Represents State Sponsored Programs in community collaborations.
Supports member access to care through home visits, processing of reports, and distribution of collateral materials.
Performs new member orientations.
Provides superior quality outcomes by taking ownership of issues to ensure timely resolution or follow-up.
Provides superior, professional, and courteous service to customers.
Comprehends the various cultural and linguistic needs of the Medicaid and SCHIP population, knowledge of the various health and social services available in the assigned region with a special emphasis on services offered by community-based organizations, ability to work professionally with the company's associates, community-based organizations, providers and plan members.
Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment.
Demonstrates strong verbal and written communication skills, both with virtual and in-person interactions.
Is attentive to details, a critical thinker, and a problem-solver.
Demonstrates empathy and persistence to resolve caller issues completely.
Shows comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
Performs other duties as assigned.