Outreach Associate - Star Plus - El Paso, Texas

Outreach Associate - Star Plus - El Paso, Texas

Job ID 2013-22801 # Positions 1
Location US-TX-El Paso
Search Category Customer Service
Type Regular Full-Time (30+ hours) Posted Date 5/8/2013
Additional Locations ..

More information about this job:
Summary:

JOB SUMMARY:

The Member Outreach Associate is responsible for providing support for Medicare quality initiatives and regulatory/contractual requirements. Support includes telephonic and in-person outreach to members who are identified as requiring outreach services. May provide assistance to quality management, and performance data collection and recording.

Responsibilities:

PRIMARY RESPONSIBILITIES:

1. Provide members with information on how to access preventive and health maintenance services while identifying barriers to care.

2. Support the implementation of quality improvement preventive health and chronic condition management interventions.

3. Track, trend, and report on Medicare established quality activities, monthly as assigned. Records and reports all provider outreach activity.

4. Promote and distribute educational materials and program information to members.

5. Assists members in making follow-up appointments with his/her Primary Care Physician (PCP) and/or Specialist as indicated by the HEDIS guidelines.

6. Provides telephone follow-up to ensure members have seen their PCP and completed or are in process of completing their treatment plan or preventive care services as defined by the PCP or guidelines

7. Promotes and supports the PCP relationship.

8. Refers issues and concerns about members to the Case Manager or Member Advocate as soon as identified.

9. Serve as a referral agent to internal services and external CBO's.

10. Assist in the maintenance of the SSO member registry database.

11. Performs other duties as assigned or requested.

Qualifications:

EDUCATION AND EXPERIENCE:

Education

Required:

High School diploma required with at least one year of experience in healthcare or managed care industry

Preferred:

College degree or equivalent preferred.

Years and Type of Experience Required:

Required:

At least one year experience in healthcare or managed care industry

Some understanding of medical terminology.

Preferred:

Experience in a health related service such as community outreach worker, home health aide, etc.

Specific Technical Skills

Required:

Bilingual - Fluent (speak, read, write) in both English and Spanish.

Computer literacy in excel and word.

Preferred:

Certifications or Licensure

Required:

Valid Driver's License and clean driving record

At least minimum insurance coverage as required by State of Texas

Preferred:

Other Required:

Good verbal communication skills.

Professional telephone skills.

Community awareness and knowledge.

Appreciation of cultural diversity and sensitivity towards targeted populations.

Must be organized and able to multi-task.

Must be able to work independently.

Must have excellent communication skills and the ability to communicate effectively with internal and external customers.

PHYSICAL REQUIREMENTS The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.

Ability to communicate both in person and/or by telephone.

Must be able to travel as needed and adhere to AMERIGROUP travel policies and procedures.

Must be able to collect medical records

Willing to work in community

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