Outreach Specialist
- Responds to telephone, written, and in-person inquiries and initiates steps to assist regarding issues relating to content or interpretation of benefits, policies and procedures.
- Provides timely and accurate resolution of inquiries and issues regarding benefits, services and policies.
- Supports and promotes State Sponsored Programs through participation in community events.
- Represents State Sponsored Programs in community collaborations.
- Supports member access to care through home visits, processing of reports, and distribution of collateral materials.
- Performs new member orientations.
- Provides superior quality outcomes by taking ownership of issues to ensure timely resolution or follow-up.
- Provides superior, professional, and courteous service to customers.
- Comprehends the various cultural and linguistic needs of the Medicaid and SCHIP population, knowledge of the various health and social services available in the assigned region with a special emphasis on services offered by community based organizations, ability to work professionally with the company's associates, community-based organizations, providers and plan members.
- Requires HS Diploma or equivalent and a minimum of 1 year of customer service experience, or any combination of education and experience that would provide an equivalent background.
- Understanding of the basic principles of managed care and the concepts of publicly financed health insurance such as Medicaid and SCHIP programs is preferred.
- For Medicaid business units, a Community Health Worker Certification must be obtained in the first 6 months of employment.
- Community Health Worker (CHW) preferred
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