Member Education Specialist

Title: Member Education Specialist

Location: Chattanooga TN 37402 Remote

Duration: 12 months

Shift: 8:30am to 5:00pm

Qualifications:

• All applicants will be advised that as a federal contractor may be required to implement a COVID19 vaccine mandate.

Education:

• High School Diploma or equivalent required

Experience:

• Customer Service experience preferred.
• Medicaid experience preferred.

Skills/Certifications:

• Microsoft Office products knowledge desired
• Effective oral communication and people skills
• Good written communication skills
• Good organizational and time management skills
• Sound decisionmaking and critical thinking skills.
• A typing test will be given.

Responsibilities:

• The position is accountable to provide member education and outreach which includes but is not limited to
• general health education on key objectives (childhood adolescent and adult development skills and needs)
• as well as chronic disease prevention and education on specific HEDIS measures with an emphasis on scheduling appointments for needed services.
• Conduct outbound educational telephone calls regarding available benefits services and programs as well as complete health needs assessments and refer members to the Population.
• Health Programs as needed
• Encourage and motivate members to become compliant by scheduling appointments and coordinating the needed appointments with provider offices.
• Be familiar with provider locations and specialties to ensure access to services.
• Coordinate transportation to and from appointments when necessary.
• Treat customers in a courteous friendly tone and professional manner
• Listen intently to customers needs and concerns.
• Be knowledgeable of member materials (written website and Facebook) and order materials when necessary.
• Be knowledgeable of HEDIS measures claims billing guidelines and health plan standards.
• Utilize member engagement techniques and offer incentives as applicable.
• Utilize systems such as Facets Care Communications Management Systems (CCMS) and Care Advance (CA)
• Manage CCMS call que daily to ensure timely completion of tasks due to the specificity of times for certain call types (for example: prenatal postpartum immunizations appointment reminders and followups)
• Educate members on available community resources as necessary.
• Be aware of physical and behavioral trauma triggers and act to engage appropriate staff.
• Assist with inbound customer service lines and/or work overtime as needed.