Quality Improvement - Member Engagement Specialist 195-1036

Job Summary

Key Responsibilities

Qualifications

Education/Experience

CommunityCare is an equal opportunity at will employer and does not discriminate

• Contact members selected for intervention.
• Aid members in creating a plan to address identified HEDIS gaps in care.
• Set up and facilitate appointments for members.
• Share information about external resources like Human Services and community services.
• Incentivize effective self-management behaviors among members.

• Compile results of interventions for analysis and trend identification.
• Present potential areas for improvement to supervisor based on interactions.
• Organize call lists and activities to optimize time usage.
• Contribute to the development of call campaigns, scripts, and other outreach methods.

• Have knowledge of HMO plans, enrollment, benefits, and claims.
• Be able to communicate effectively with various types of individuals.
• Show high levels of organization and attention to detail.
• Be proficient in Microsoft applications.
• Display excellent problem-solving skills.
• Possess strong oral and written communication skills.
• Successfully complete a Health Care Sanctions background check.

• Hold a high school diploma or equivalent.
• Benefit from a bachelor's degree in English, Communications, Social Science, Marketing, Business, or a similar field.
• Have experience working with the elderly or geriatrics.
• Have experience with "face-to-face" customer experiences.
• Have three years of previous customer service experience.
• Be cross-trained and functional on three or more lines of business.