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Job ID: 2012-17768 # Positions: 1 Location: US-NY-New York Search Category: Health Care Operations Type: Regular Full-Time (30 hours) Posted Date: 1/27/2012
More information about this job: Summary:
The Member Outreach Associate is responsible for providing support for clinical 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 clinical compliance staff with member education classes, quality management, and Health Promotion initiatives and performance data collection and recording.
Responsibilities:
1. Provide members with information on how to access preventive and health maintenance services while identifying barriers to care.
2. Arrange transportation for members as needed, if applicable.
3. Conducts telephonic and/or home visit education with members (e.g., compliance with state required programs such as the EPSDT program, appropriate ER utilization).
4. Collect member encounter data and medical records.
5. Review medical records for completeness.
6. Promote and distribute educational materials and program information to members.
7. Assists members in making follow-up appointments with his/her Primary Care Physician (PCP) and/or Specialist as indicated by the guidelines of the disease management or large case management program in which they participate.
8. 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
9. Promotes and supports the PCP relationship.
10. Refers issues and concerns about members to the Case Manager or Member Advocate as soon as identified.
11. Serve as a referral agent to internal services and external CBO's.
12. Educates members and providers about Plan policies, programs and services when contacts result in questions, concerns or identified learning needs.
13. Assists members in identifying community resources for the management of their disease as directed by the Case Manager.
14. Assists members in obtaining appropriate health education materials, classes and programs for the required level of care.
15. Documents member participation of member outreach activities as appropriate.
16. Records and reports all member outreach activity.
17. Performs other duties as assigned or requested.
Qualifications:
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:
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:
Computer literacy in excel and word.
Certifications or Licensure
Required:
Valid Driver's License and clean driving record
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.
Preferred:
Bilingual skills in Spanish or Chinese a plus.
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. - For NY Plan Outreach only: - Must be able to work weekends, off shifts and/or evenings as directed. - Must be able to travel by MTA (Bronx, Brooklyn, Manhattan, Staten Island and Queens). - Must be able to conduct home/provider visits as directed. - Must be able to work outreach/Health promotions events (Bronx, Brooklyn, Manhattan, Staten Island and Queens)
