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Care Engagement Specialist

Company: Centene
Location: Louisville
Posted on: June 12, 2021

Job Description:

Position Purpose: Care Engagement is responsible for supporting the organization's 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.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 fluence 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.Position Purpose: Care Engagement is responsible for supporting the organization's 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.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 fluence 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 3+ years of sales experience in a call center or other high pressure sales environment, or experience in member, provider, customer service, or call center; or Bachelor degree in healthcare, business administration, or related field and 1+ years of sales experience in a call center or other high pressure sales situation, or experience in member, provider, customer service, or call center. Bilingual in Spanish and English preferred.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.Education/Experience: High School diploma or equivalent and 3+ years of sales experience in a call center or other high pressure sales environment, or experience in member, provider, customer service, or call center; or Bachelor degree in healthcare, business administration, or related field and 1+ years of sales experience in a call center or other high pressure sales situation, or experience in member, provider, customer service, or call center. Bilingual in Spanish and English preferred.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.Customer ServiceCustomer ServiceUSA-Kentucky-LouisvilleUSA-Kentucky-LouisvilleUSA-Kentucky-Bowling Green, USA-Kentucky-HazardUSA-Kentucky-Bowling Green, USA-Kentucky-HazardWellCare of KYWellCare of KYFull-timeFull-time

Keywords: Centene, Louisville , Care Engagement Specialist, Other , Louisville, Kentucky

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