- Engage and motivate members to participate in the various case management programs by clearly articulating the goals, benefits and interventions.
- Complete a comprehensive assessment tailored to the reason for case management eligibility and refer to nurse case management when member's response triggers criteria for referral and need for licensed clinical intervention/case management
- Provide personalized navigation support to members to help them move through the healthcare system, by ensuring understanding of health plan benefits. This is accomplished by educating and connecting members to resources and support services, including community resources and access to transportation
- Perform outreach to PCP/POC's, specialists, and home care providers to research and facilitate referral of members for services
- Schedules telephone appointments with members to speak with a nurse case manager or assists in scheduling appointments with provider offices at the members' request
- Excellent telephonic skills
- Ability to multi-task and handle inventory
- Independent critical thinking
- Demonstrates strong interpersonal skills that reflects cultural awareness in dealing with members
- Demonstrates the ability to build and maintain effective, collaborative work relationships as well as professional and meaningful connections with members
- Minimum 2-3 years of customer/member service experience or telephonic health coaching experience is required
- BS/BA or AS/AA degree in healthcare field, or related area is preferred or equivalent work experience
- Knowledge of medical terminology required
- Experience in a call center strongly, preferred
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Care Management Extender - Hingham, United States - Blue Cross Blue Shield of Massachusetts
Found in: Lensa US P 2 C2 - 3 weeks ago
Description
Ready to help us transform healthcare? Bring your true colors to blue.
The Role
The Care Management Extender position is a member of the care management team and works collaboratively with nurse case managers to outreach to members who have been identified for case management services.
The primary function of this position is to place outbound calls and serve as the first point of contact with members who are identified as a potential candidate for case management. The case management extender will conduct a brief assessment scripted based on the reason the member triggered for case management.
The Team
As an integral part of Business Operations, the Extender must demonstrate an understanding of the department business objectives and measures including performance guarantees linked to case management engagement rates.
Key Responsibilities:
Key Qualifications:
Education and Experience:
Minimum Education Requirements:
High school degree or equivalent required unless otherwise noted above
Location
HinghamTime Type
Full timeHourly Range: $ $34.02The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.
This job is also eligible for variable pay.
We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
WHY Blue Cross Blue Shield of MA?
We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.
As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join our Talent Community to stay "in the know" on all things Blue.
At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.
