Wellness Guide I

Partnership HealthPlan of California•Fairfield, CA

5d•$30 - $35

About The Position

The Wellness Guide I supports and guides Partnership HealthPlan of California members regarding wellness services and incentive programs in a call-center environment. The role works with members and their families to encourage healthy activities, including preventive care visits and chronic care management, explain available benefits, and connect members with internal and external resources. The position performs outreach for wellness campaigns, discusses programs and screening opportunities, helps members schedule wellness appointments, and maintains an active caseload and appropriate call volume. It screens members, conducts targeted assessments, and initiates referrals to providers, community resources, and Partnership programs in accordance with applicable guidelines and policies. It also documents activity, answers and routes calls, responds to inquiries, and communicates professionally with members and a range of internal and external partners. The role may support other Wellness Guide staff, collaborate with Partnership departments, attend required meetings and training in person when assigned, and provide periodic coverage for colleagues. Other duties may be assigned by the direct supervisor. The work is performed at a standard cubicle workstation with a shared common area. The position uses a telephone, fax, computer, and photocopying machine, and involves sitting at a computer and talking on the telephone for a major portion of the workday. The employee must be able to work in a fast-paced environment and maintain courtesy and composure. Face-to-face member contact may be expected, and lifting, moving, or carrying objects weighing up to 35 pounds may be required when necessary.

Requirements

High school diploma or equivalent combination of experience and education required.
Two years of experience working in a health care setting recommended, including health coaching, behavioral change, or other work experience, training, or specialized education likely to provide the ability to perform the essential functions.
Ability to use good judgment, take personal initiative, and exercise discretion.
Attention to detail and accuracy.
Basic knowledge of medical terminology and coding.
Ability to listen actively and practice motivational interviewing.
Ability to use word processing, spreadsheet, and email software, including operating multiple computer programs simultaneously.
Ability to function effectively amid frequent interruptions and direction from multiple team members.
Ability to work effectively with diverse individuals and groups and establish collaborative relationships.
Ability to work autonomously within a team setting.
Ability to prioritize workload and initiate action to obtain needed information from professionals by phone.
Ability to communicate clearly and effectively with members, providers, vendors, community partners, and Partnership employees.
Ability to model appropriate behavior for the department and work effectively with Medi-Cal and other special needs populations.
Ability to work with ethnically and culturally diverse populations and maintain positive, cooperative relationships with the community, professional groups, public officials, and agencies.
Ability to represent the department professionally and manage multiple tasks.
Ability to sit at a computer and talk on the telephone for a major portion of the workday.
Ability to lift, move, or carry objects weighing up to 35 pounds when necessary.

Nice To Haves

Associate’s or bachelor’s degree preferred.
Preference may be given to individuals certified and/or licensed in a health-related field.
Bilingual skills in a Partnership threshold language preferred.

Responsibilities

Perform wellness campaign outreach for assigned memberships and campaigns.
Provide members with information about wellness benefits and help schedule appointments for wellness services.
Engage members in discussions about wellness programs and health screening opportunities.
Maintain an active caseload and call volume appropriate to the acuity of the outreach campaign.
Screen members and refer them to community resources, providers, and Partnership resources and programs according to department guidelines.
Conduct targeted assessments to encourage members to remain healthy and support campaign goals.
Initiate and process referrals to appropriate Care Coordination programs in accordance with Partnership policies.
Complete timely and accurate documentation in appropriate systems and according to department policies.
Respond to member queries on the ACD telephone line, determine call urgency, and route calls appropriately.
Provide excellent customer service and communicate according to Partnership standards and expectations.
Communicate clearly with members, providers, vendors, community partners, and Partnership employees through all communication mediums.
Respond to inquiries in a timely manner.
Connect members to wellness services and community resources as appropriate.
Maintain professional standards in accordance with Partnership's Code of Conduct.
Provide support and assistance to Wellness Guide staff as needed.
Collaborate with internal Partnership departments to resolve issues.
Attend required meetings and trainings in person when assigned.
Provide periodic coverage for Wellness Guide staff during vacations or sick time as needed within the assigned team.
Perform other duties as assigned by the direct supervisor, including assuming new duties.
Provide high-quality service, promote teamwork, maintain safe practices, and follow HealthPlan policies and procedures.