Description:

Summary:

Care Engagement is responsible for supporting the organizations goals of obtaining health needs screenings scheduling preventive service appointments and educating members on plan benefits and services.

Provide members with educational materials and carry out strategies to increase health care adherence and reduce barriers to care.

Job Responsibilities: Make outbound or receive inbound calls from members to schedule doctor appointments assist members that need to complete Health Needs Screenings or make payments to become eligible for enhanced benefits. Influence members to take advantage of additional benefits available by educating members on enhanced services that are available and recommending preferred providers.

Educate members on utilization of Emergency Departments in non-emergent conditions and the impact to their benefits. Identify and overcome barriers in order for members to complete needed health screenings obtain needed services or make payments to secure enhanced benefits.

Review each member profile prior to outreach to identify areas of opportunity which includes but is not limited to reviewing additional benefits available for members and identify opportunities for members to become eligible for additional benefits.

Participate in continuous quality improvement initiatives to ensure department and company goals are met and exceeded. Review and analyze data for call reports to make adjustments as needed to call approach for members in order to obtain information. Act as a secondary resource for the Member Services or Provider Services call centers.

Education/Experience: High School diploma or equivalent and 0-2 years of sales experience in a call center or other high pressure sales environment. Bilingual in Spanish and English preferred.

Additional Skills & Qualifications:

Required Skills/Experience:

1. 2+ years of customer service experience, preferably in a healthcare.

2. Experience with Microsoft office applications

3. Strong verbal and written communication skills.

Education Requirement: High school diploma

Preferred Skills/ Experience:

1. MEDICARE and/or MEDICAID experience

2. HEDIS, STARS, CAHPS, NCQA experience

Experience Level:

Entry Level

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.