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023680 Clin Alli-Onboarding & Scheduling

Position Summary

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.

Supervision Exercised: No

Essential Duties & Responsibilities

+ Serves as the primary member contact and advocate until their care team is established, both through direct member outreach and inbound call support

+ Leverages internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful contact information for unreachable or hard-to-reach members

+ Orients new members to the value of CCA as their health plan, providing education, answering members’ questions, anticipating, and meeting member needs and concerns

+ Documents members’ current healthcare services and new service requests

+ Ensures members continue to receive current healthcare services as they transition to CCA through healthcare provider outreach and education

+ Schedules new members’ initial nurse intake visits

+ Utilizes 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 CCA

+ Utilizes established workflows and collaborates with internal and external stakeholders and healthcare providers

+ Provide clinical care to members via telehealth technologies (video, chat, etc.) for a clinically appropriate clinical care and care management services.

Working Conditions

Office environment with extensive telephonic communication

Required** **Education

Bachelor’s Degree or relevant experience in call center and/or Medicare/Medicaid plan

Required** **Experience

+ 5+ years’ experience

+ 1+ years’ experience working in outreach or in the community with individuals who have behavioral, medical, social, or interpersonal complexities impacting their lives

+ Experience working in a multi-cultural setting

+ Experience using motivational interviewing techniques in a professional setting

Desired Experience

+ Experience identifying unmet healthcare needs and escalating to the appropriate individual preferred

+ Experience with electronic medical record and care management systems strongly preferred

Required** **Knowledge, Skills & Abilities

+ Demonstrated understanding of the community served

+ Familiarity with data entry and querying databases to identify key information about members

+ Excellent communication skills, including the ability to convey information clearly telephonically and in a culturally sensitive manner

+ Strong interpersonal and customer relation skills, including active listening skills, dependability, and responsiveness

+ Compassionate, understanding, and patience

+ Motivates, empowers, inspires, and collaborates with members while effectively establishing boundaries by clarifying roles, expectations, and deliverables

+ Ability to develop and maintain positive working relationships with peers, supervisors, and other organizations

+ Ability to multitask and ensure all work is completed thoroughly and completely in a fast-paced environment with competing demands

+ Basic computer skills

+ Professional, comprehensive, clear documentation

+ Familiarity with Microsoft Office programs: Outlook, Calendar, Word

+ Willing to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.

Desired** **Knowledge, Skills & Abilities

+ Knowledge of some medical terminology preferred

Required Language(s)

English

Desired Language(s)

Bilingual preferred

Other

+ The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job

+ Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

+ While performing the duties of this job, the employee is regularly required to stand; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear

+ The employee is occasionally required to walk; sit; and stoop, kneel, crouch, or crawl

+ The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move more than 100 pounds

+ Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.