serve as the primary member contact and advocate until their care team is established, both through direct member outreach and inbound call support
leverage internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful contact information for unreachable or hard-to-reach members
orient new members to the value of CCA/CareSource as their health plan, providing education, answering members’ questions, anticipating, and meeting member needs and concerns
document members’ current healthcare services and new service requests
ensure members continue to receive current healthcare services as they transition to CCA/CareSource through healthcare provider outreach and education
schedule new members’ initial nurse intake visits
utilize communication skills such as motivational interviewing to gain agreement from members to participate in the onboarding process
utilize established workflows and collaborate with internal and external stakeholders and healthcare providers
provide clinical care to members via telehealth technologies (video, chat, etc.) for clinically appropriate clinical care and care management services

Bachelor's Degree or relevant experience in call center and/or Medicare/Medicaid plan required
equivalent years of relevant work experience may be accepted in lieu of required education
five (5) years of relevant experience required
one (1) year working in outreach or in the community with individuals who have behavioral, medical, social, or interpersonal complexities impacting their lives required
experience working in a multi-cultural setting required
experience using motivational interviewing techniques in a professional setting required
experience identifying unmet healthcare needs and escalating to the appropriate individual preferred
experience with electronic medical record and care management systems strongly preferred

Onboarding Specialist

Key skills