Member Engagement Specialist

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Full Time Cary, NC, US

About CCNC:

From the mountains to the coast, from large cities to small towns, Community Care of North Carolina is transforming health care. Informed by statewide data and predictive analytics, community-based care-managers work with local physicians and diverse teams of health professionals to develop whole-person plans of care that connect people to the right local resources and increase equity and access to high quality care.

CCNC Mission Statement

To improve the health and quality of life for all North Carolinians by building supporting better community-based healthcare delivery systems.

Position Summary

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 (plan) programs and offerings.

The Member Engagement Specialist interacts with members, providers and other staff to implement program interventions, document activities, and refer risk appropriate members to professional staff according to protocols. The candidate for this position must have a disposition towards 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.

Essential Functions

• Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services.
• Receive and manage referrals from data reports; clinical care management team members, PCP, or other service providers for efficient screening and linking members with care management.
• Complete and document member screenings tools and refer clinical needs to 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 daily and monthly program productivity and engagement metrics.
• 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.
• Abide by department guidelines, company policies, and HIPAA regulations.
• Perform other duties that assist in keeping the operation organized and functional.
• Attend departmental and corporate meetings.
• Understand and uphold CCNC goals, objectives, and standards.

Qualifications

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

Knowledge, Skills, and Abilities

• Strong Initiative
• Performance metric driven and productivity mindset
• Strong oral and written communication proficiency
• 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
• Ability to provide information in a manner that is culturally and linguistically appropriate
• Knowledge of and experience working in member or clinical data systems
• Computer skills required including various office software and the internet; experience with MS Office software preferred

Working Conditions

• The job environment is primarily an office or home environment.
• Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time and repetitive wrist motion
• Travel using personal vehicle may be required within the region and/or the State
• The job environment can be intense as high…