Cust Svc Member Outreach Spec (Remote in Oregon)

Samaritan Health Services Remote
spec remote health customer service confidentiality lift community medicaid medicare management assistant procedures communication
November 18, 2022
Samaritan Health Services
Corvallis, OR 97333, OR

JOB SUMMARY/PURPOSE Performs outbound calls to activate and engage members in various programs and campaigns to promote the health and wellbeing of our members. This includes initial outreach, follow-up and documentation of information obtained from the member. Uses exceptional customer service skills and motivational interviewing to engage members in participating in the various programs and services offered by SHP and key stakeholders in the community. DEPARTMENT DESCRIPTION Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services# self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services# mission of Building Healthier Communities Together. EXPERIENCE/EDUCATION/QUALIFICATIONS High school diploma or equivalent required. Associate#s or college degree preferred. Two (2) years of related work experience in health care, customer service, telemarketing, account management, and/or sales required. One (1) experience in a call center required. One (1) year experience equivalent to an SHS Customer Service Rep II role or in a lead/senior role required. Experience with computers (including knowledge of Microsoft Word, Outlook, and Excel) required. Experience working with Medicare, Medicaid or Special Needs populations preferred. Medical Assistant, Certified Nursing Assistant, traditional health worker, or community care coordination experience preferred. Must be able to pass Criminal Records check upon hire and every three (3) years thereafter. KNOWLEDGE/SKILLS/ABILITIES Clerical: Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, and other office procedures and terminology. Communication: Excellent communication and phone etiquette skills. Able to interact with colleagues, providers, members, customers and external organizations to successfully engage and motivate. Ability to show tact and professionalism in dealing with a variety of people. Proficient with active listening skills, while building a positive connection to support SHP in successful customer experience scores, quality metrics and key campaigns to engage in services to support the members obtaining the services and care available to them. Customer Service: Knowledge of principles and processes for providing an exceptional Customer Experience. This includes customer needs assessment, meeting quality standards for services and evaluation of customer satisfaction. Computer Literacy: Proficient computer skills in department applications. Time Management: Ability to organize, plan and prioritize work to complete within required time frames and to follow-up on pending issues. Ability to perform multiple tasks simultaneously and thrive in dynamic fast-paced environments and under pressure. Confidentiality: Knowledge of State and Federal (HIPAA) laws pertaining to confidentiality of protected health information. Ability to comply with laws and maintain confidentiality of patient information. Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm. PHYSICAL DEMANDS Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 # 100% of the time) CLIMB - STAIRS LIFT (Floor to Waist: 0#-36#) 0 - 20 Lbs LIFT (Knee to chest: 24#-54#) 0 # 20 Lbs LIFT (Waist to Eye: up to 54#) 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) STAND WALK # LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers #



  • JOB SUMMARY/PURPOSE


  • Performs outbound calls to activate and engage members in various programs and campaigns to promote the health and wellbeing of our members. This includes initial outreach, follow-up and documentation of information obtained from the member. Uses exceptional customer service skills and motivational interviewing to engage members in participating in the various programs and services offered by SHP and key stakeholders in the community.



  • DEPARTMENT DESCRIPTION


  • Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services' self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services' mission of Building Healthier Communities Together.



  • EXPERIENCE/EDUCATION/QUALIFICATIONS


  • High school diploma or equivalent required. Associate's or college degree preferred.




  • Two (2) years of related work experience in health care, customer service, telemarketing, account management, and/or sales required.




  • One (1) experience in a call center required.




  • One (1) year experience equivalent to an SHS Customer Service Rep II role or in a lead/senior role required.




  • Experience with computers (including knowledge of Microsoft Word, Outlook, and Excel) required.




  • Experience working with Medicare, Medicaid or Special Needs populations preferred.




  • Medical Assistant, Certified Nursing Assistant, traditional health worker, or community care coordination experience preferred.




  • Must be able to pass Criminal Records check upon hire and every three (3) years thereafter.



  • KNOWLEDGE/SKILLS/ABILITIES


  • Clerical: Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, and other office procedures and terminology.




  • Communication: Excellent communication and phone etiquette skills. Able to interact with colleagues, providers, members, customers and external organizations to successfully engage and motivate. Ability to show tact and professionalism in dealing with a variety of people. Proficient with active listening skills, while building a positive connection to support SHP in successful customer experience scores, quality metrics and key campaigns to engage in services to support the members obtaining the services and care available to them.




  • Customer Service: Knowledge of principles and processes for providing an exceptional Customer Experience. This includes customer needs assessment, meeting quality standards for services and evaluation of customer satisfaction.




  • Computer Literacy: Proficient computer skills in department applications.




  • Time Management: Ability to organize, plan and prioritize work to complete within required time frames and to follow-up on pending issues. Ability to perform multiple tasks simultaneously and thrive in dynamic fast-paced environments and under pressure.




  • Confidentiality: Knowledge of State and Federal (HIPAA) laws pertaining to confidentiality of protected health information. Ability to comply with laws and maintain confidentiality of patient information.




  • Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm.



  • PHYSICAL DEMANDS

  • Rarely


(1 - 10% of the time)


Occasionally


(11 - 33% of the time)


Frequently


(34 - 66% of the time)


Continually


(67 - 100% of the time)


CLIMB - STAIRS


LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs


LIFT (Knee to chest: 24"-54") 0 - 20 Lbs


LIFT (Waist to Eye: up to 54") 0 - 20 Lbs


CARRY 1-handed, 0 - 20 pounds


BEND FORWARD at waist


KNEEL (on knees)


STAND


WALK - LEVEL SURFACE


ROTATE TRUNK Standing


REACH - Upward


PUSH (0 - 20 pounds force)


PULL (0 - 20 pounds force)


SIT


CARRY 2-handed, 0 - 20 pounds


ROTATE TRUNK Sitting


REACH - Forward


MANUAL DEXTERITY Hands/wrists


FINGER DEXTERITY


PINCH Fingers


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