Supports area clinical team and serves as a proactive resource for members related to disease prevention and benefit education.

Job Responsibilities:
* Conducting educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
* Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
* Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
* Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries.
* Work overtime as needed
* Various immunizations and/or associated medical tests may be

Job Qualifications
Education
* Associates Degree in, education, communication, or health related field or equivalent work experience

Experience
* 2 years - Experience in a customer service support role is required

Skills\Certifications
* Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and
accountability.
* Proficient interpersonal and organizational skills
* Independent, Sound decision-making and problem-solving skills
* Must be able to work in an independent and creative manner.
* Self-motivated and able to manage multiple tasks and set priorities.
* Effective time management skills
* Excellent oral and written communication skills
* Strong interpersonal and organizational skills
* Knowledge in Medical terminology

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