Onboarding Specialist

hace 1 mes


Puerto Diablo, Puerto Rico Commonwealth Care Alliance A tiempo completo

Why This Role is Important to Us

The Onboarding Specialist is the primary contact for members as they transition to a CCA health plan. The Specialist contacts new members via telephonic outreach and identifies both the member's existing healthcare services that will continue and new service requests. The Specialist works to ensure that member needs are addressed through liaising with internal CCA providers and external healthcare providers. The Specialist also educates the member on health plan offerings and addresses members' questions or concerns.

What You'll Be Doing

** This position coversAllston, Arlington, Auburndale, Belmont, Billerica, Brighton, Burlington, Chelmsford, Chestnut Hill, Dunstable, Lexington, Lowell, Medford, Newton, North Billerica, Reading, South Chelmsford,Stoneham, Tyngsborough, Waltham, Watertown, Winchester, Woburn**

Serves as the primary member contact and advocate until their care team is established, both through direct member outreach and inbound call supportLeverages internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful contact information for unreachable or hard-to-reach membersOrients new members to the value of CCA as their health plan, providing education, answering members' questions, anticipating and meeting member needs and concernsDocuments members' current healthcare services and new service requestsEnsures members continue to receive current healthcare services as they transition to CCA through healthcare provider outreach and educationSchedules new members' initial nurse intake visitsUtilizes communication skills such as motivational interviewing to gain agreement from members to participate in the onboarding process, persistently forging trusting relationships and engaging individuals not readily interested in connecting with CCAUtilizes established workflows and collaborates with internal and external stakeholders and healthcare providersProvide clinical care to members via telehealth technologies (video, chat, etc.) for a clinically appropriate clinical care and care management services. What We're Looking For

Qualifications:

Bachelor's Degree or relevant experience in call center and/or Medicare/Medicaid plan required5+ years' experience required1+ years' experience working in outreach or in the community with individuals who have behavioral, medical, social, or interpersonal complexities impacting their lives requiredDemonstrated understanding of the community served requiredExperience working in a multi-cultural setting requiredExperience using motivational interviewing techniques in a professional setting requiredFamiliarity with data entry and querying databases to identify key information about members requiredExperience identifying unmet healthcare needs and escalating to the appropriate individual preferredExperience with electronic medical record and care management systems strongly preferredExcellent communication skills, including the ability to convey information clearly telephonically and in a culturally sensitive manner requiredStrong interpersonal and customer relation skills, including active listening skills, dependability, and responsiveness requiredCompassionate, understanding, and patience requiredMotivates, empowers, inspires, and collaborates with members while effectively establishing boundaries by clarifying roles, expectations, and deliverablesAbility to develop and maintain positive working relationships with peers, supervisors, and other organizationsAbility to multitask and ensure all work is completed thoroughly and completely in a fast-paced environment with competing demandsBasic computer skillsProfessional, comprehensive, clear documentationFamiliarity with Microsoft Office programs: Outlook, Calendar, WordWilling to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.English required, Bilingual preferred



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