Member Engagement Specialist

Member Engagement Specialist at Community Care of North Carolina

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The Member Engagement Specialist is responsible for telephonic outreach and screening of identified members based on plan stratification for care management with a call center approach. An experienced and energetic communicator, the engagement specialist is focused on deepening program participation as well as making members aware of CCNC (Community Care of North Carolina) plan programs and offerings.

The Member Engagement Specialist interacts with members, providers, and other staff to initiate program interventions, document activities, and refer risk‑appropriate members to professional staff according to protocols. The candidate for this position must have a disposition toward good customer service, be assertive without being aggressive, and always maintain a professional demeanor. The Member Engagement Specialist may work remotely within regions to cover the needs across the state.

This is primarily a remote position; occasional in‑person training and travel may be required.

• Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services.
• Receive/retrieve and manage referrals from data reports, clinical care management team members, PCPs (Primary Care Providers), or other service providers for efficient screening and linking members with care management.
• Complete and document member screening tools and refer clinical needs to the most appropriate clinical care management team member for assessment and follow up.
• Schedule members for face‑to‑face or telephonic encounters for care management follow up.
• Meet monthly productivity and role expectations.
• Complete all assignments within expected time frames.
• Notify supervisor promptly of any issues with receiving or sending referrals, making timely care management assignments, or issues with carrying out any other duties assigned.
• Collaborate with the Care Team to address barriers and create efficiency with processes.
• Abide by department guidelines, company policies, and HIPAA regulations.
• Perform all other duties as requested.
• Attend departmental and corporate meetings.
• Understand and uphold CCNC goals, objectives, and standards.

• High School/GED.
• Prior telephonic call center experience desired.
• Minimum of two years previous work experience, preferably in a health care setting.
• Health care experience and medical terminology knowledge highly preferred.
• Bilingual preferred.
• Managed care experience a plus.

• Computer skills required including various office software and the internet; experience with MS Office software preferred.
• Strong initiative.
• Performance metric driven and productivity mindset.
• Strong oral and written communication proficiency.
• Attention to detail.
• Organizational and time‑management skills.
• Strong interpersonal skills.
• Critical thinking skills.
• Resourceful – able to shift strategy or approach in response to the demands of a situation.
• Team‑oriented.
• Adaptable – responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives.
• Motivational interviewing skills.
• Knowledge of care management principles.
• Ability to work independently and to use sound judgment when needed.
• Multi‑tasking abilities.
• Outgoing and energetic attitude.
• Respectful customer service skills.
• Ability to provide information in a manner that is culturally and linguistically appropriate.
• Knowledge of and experience working in member or clinical data systems.

• May involve some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time and repetitive wrist motion.
• Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices.
• Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds.
• The job environment is a home environment.
• Travel using personal vehicle may be required within the region and/or the state.
• The job environment can be intense as high volume, repetitive work is an expectation.