Outreach Specialist

Job Description

Job Description

Job Summary

As an Outreach Specialist, you play a pivotal role in the engagement and enrollment of TRICARE beneficiaries in Case Management, Care Coordination and Disease Management programs. You will make outbound and receive inbound phone calls to influence beneficiaries to actively manage their healthcare, obtain needed resources, and understand all the TRICARE benefits afforded to them. You set the stage for increased engagement and adherence to our program by utilizing motivational interviewing and other techniques to identify motivations, goals and clinical needs of TRICARE beneficiaries.

Government Reporting

Direct

Education & Experience

Required

• High School Diploma or G.E.D.
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation.
• Minimum 2 years’ experience in a health care customer service environment
• Experience with Microsoft Office suite
• Experience within the healthcare industry and operations along with medical terminology

Preferred

• Medical Assistant (MA) or Certified Nursing Assistant (CNA)
• Prior experience in a Managed Care Organization (MCO)
• Prior experience with TRICARE or VA health plans

Key Responsibilities

• Review each beneficiary’s profile prior to outreach to identify areas of opportunity, which includes but is not limited to reviewing additional benefits available for beneficiaries and identify opportunities for beneficiaries to become aware of additional benefits.
• Identify and overcome barriers in order for beneficiaries to complete needed health screenings and obtain needed services.
• Act as a subject matter expert on clinical programs, tools and benefits in order to ensure beneficiaries understand what valuable services and programs are available to them.
• Prep and schedule beneficiaries for their initial appointment with a clinician or health coach.
• Documentation of preferred beneficiary outreach and communication preferences.
• Comply with HIPAA privacy laws and all other federal, state, and local regulations
• Protect and maintain the confidentiality of company and customer information, policies, and processes
• Performs other duties as assigned

Competencies

Technical Skills

Working knowledge of the healthcare system and medical terminology. Knowledge of TRICARE programs and benefits, managed care programs or other government healthcare programs.

Problem Solving / Analysis

Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues.

Organizational Skills

Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.

Multi-Tasking / Time Management

Prioritize and manage actions to meet changing deadlines and requirements within a high volume, sometimes stressful environment.

Independent Thinking / Self-Initiative

Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources.

Communication / People Skills

Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.

Team-Building / Team Player

Influence the actions and opinions of others in a positive direction and build group commitment. Respectful behavior in a diverse workforce

Empathy / Customer Service

Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position. Respectful behavior when working with a diverse population

Computer Literacy

Ability to function in a multi-system Microsoft environment using Word, Outlook, TEAMs, TriWest Intranet, the Internet, and department software applications.

Commitment to Task

Ability to conform to established policies and procedures; exhibit high motivation.

Working Conditions

Working Conditions

• Extensive computer work with prolonged sitting
• Virtual team members and workflows
• Ability to do repetitive work and maintain production standards
• Department of Defense security clearance required

** This job description indicates the general nature and levels of work expected of the incumbents. It is not designed to cover or contain a comprehensive listing of activities, duties, responsibilities or competencies required of an incumbent. Incumbents may be asked to perform other duties as required. **