In collaboration with program leadership staff, the Managed Care Outreach Associate manages outreach activities across multiple managed care organizations (MCO) of Pillars Community Health. The Managed Care Patient Outreach Associate (MCPA) will support families entering the Pillars Community Health system for medical, dental, behavioral health or psychiatry services.
ESSENTIAL DUTIES & RESPONSIBILITIES
- Conducts outreach calls to patients daily
- Contacts new members to educate them on how to utilize their plan benefits, how to navigate the care system, and provides them with resources to resolve their inquiries or questions.
- Evaluates the approaches used for outreach, reports to supervisor, and works collaboratively with team and supervisors to adjust their approach based on patient’s needs.
- Gathers and analyzes reports from each managed care provider portal; uses data to work with program leaders in determining which reports to work on. Establishes and maintains a working list of patient outreach and follow up activities.
- Works collaboratively and strategically with Marketing, Community Outreach, and other appropriate service line leadership to retain patients and clients of Pillars Community Health.
- Maintains appropriate and accurate logs of patients that are assisted. Logs include information such as: patient name, MRN, dates of calls, outcome of calls, date appointment is scheduled, other care providers, and any other follow up data point to resolve gaps in care
- Provides documentation of all activities related to outreach and the number of participants in designated worklogs or patient’s electronic records
- Contacts patient at least once every 30 days to assist with scheduling appointments and educating on gaps in care from reports in Managed Care Company platforms.
- Attends monthly and quarterly quality meetings with the managed care companies
- Maintains login credentials for various managed care companies and completes required training to learn how to navigate MCO platforms and pull various reports for outreach purposes.
- Under the direction of the Senior Vice President of Health Center Services, provides information to patients/clients and their families about the health center’s services through various methods of communication, including, one-on-one patient/client interactions, phone calls, events, e-mail, etc.
- As a trusted advocate for patients, serves as a link between patient/client and critical care services of the health center, behavioral health and/or other human services provided through the organization.
- Serves as a liaison for patients/clients to critical internal services such as Benefits Counselors and Registration Staff to assure patient receives additional assistance or information as needed.
- Provides bilingual (Spanish/English) services to patients/clients needing such assistance.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and or ability required. Reasonable accommodations may be made to enable an individual with a disability to perform the essential duties and responsibilities.
EDUCATION & EXPERIENCE
High School diploma or equivalent combination of education and training. Customer Service experience required. Prior experience working in an administrative support role in a medical office or health center environment required. Prior outreach experience preferred.
Bilingual fluency in Spanish/English required
- Practices cultural humility with a commitment to reducing barriers to healthcare for marginalized and/or low-income individuals
- Passion for public health outreach and serving the low-income population
- Computer proficiency in electronic health records preferred; internet and e-mail, Microsoft Office software and/or Google Docs required
- Highly organized with ability to multi-task and willingness to learn new tasks
- Excellent oral and written communication and interpersonal skills
- Ability to track and input data
- Ability to work within a team environment
- Critical and analytical thinker with ability comprehend and retain information for on-the-spot use
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