Quality Improvement - Member Engagement Specialist 195-1036
On-site · Tulsa, Oklahoma, United States
Job Summary
Responsible for completing out-bound member outreach to select members to address identified HEDIS gaps in care, assisting members with developing plans to resolve those gaps, arranging transportation to appointments, sharing information on external resources, and encouraging effective self-management behaviors. Roles include developing and executing call campaigns and scripts, coordinating with supervisors and clinical coordinators on clinically-related questions, compiling results for analysis, and collaborating on QI projects and outreach activities (mailings, web-based outreach or on-site events). Emphasis on organizing call lists, tailoring interventions by objective and member demographics, and contributing to quality program activities 100% of the time.
Required Qualifications
- High school diploma or equivalent; Bachelor's degree preferred in English, Communications, Social Science, Marketing, Business or similar (preferred)
- Three years of customer service experience; experience in healthcare/insurance industry preferred
- Experience with elderly or geriatrics preferred
- Experience with face-to-face customer service
- Knowledge of HMO plans, enrollment, benefits, and claims
- Bilingual preferred
- Proficient in Microsoft applications
- Strong oral and written communication skills
- Successful completion of Health Care Sanctions background
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