Quality Outreach Unit Representative II - JHP

Quality Outreach Representative II

The Quality Outreach Representative II is part of the Quality Improvement and Performance Team, working in a fast-paced call center environment. Quality Outreach Representatives make outbound calls to both new and existing HPP members to schedule PCP/Specialist visits as well as provide the members with exceptional customer service. Quality Outreach Representatives are responsible for member engagement through various outreach programs aimed at improving quality improvement initiatives and member satisfaction aligned with the organization's HEDIS, Stars, and NCQA Accreditation goals.

The main objective of this position is to proactively address members' open gaps in care and provide our members the opportunity to voice any concerns about their plan and assist them to better manage their healthcare needs.

Essential Functions:

• Able to work in a constant state of alertness and safe manner
• Serve as front-line liaison between members and HPP, reaching out to members with care, compassion, patience, and professionalism to foster member satisfaction from the start
• Answer eligibility, benefit, and provider inquiries, assuring that members receive optimal service, take advantage of all available benefits and gain a high level of satisfaction with the plan
• Coordinate care for our members by conducting outreach calls and reminder calls to members, calls to providers to obtain appointments and test orders as well as coordinating multiple specialists' appointments for members
• Collaborate with internal departments to facilitate resolutions to member issues and concerns
• Document appropriately in various internal systems as outlined by the supervisor and the Policy & Procedures of the department
• Operate telephone systems effectively and efficiently, following established protocols for security, transfer and information exchange
• Assist the supervisor by taking on additional tasks and responsibilities to improve the overall productivity of the department
• Assist in the completion of various research projects related to quality improvement

Required

Education and Experience:

• High School Diploma or equivalent required.

Skills/Abilities:

• Excellent telephone communication required;
  Bilingual preferred (Spanish).
• Ability to work independently and as part of a team required
• Exceptional customer service skills required
• Ability to multitask and work in a fast-paced call center environment required
• Computer literate, able to learn computer programs easily preferred

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Health Partners Plans, Inc.

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.