Jobs search

Customer Service Member Outreach Specialist

Samaritan Health Services • Corvallis, Oregon, United States • 4w ago

Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth 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.

Candidates residing out of state will need to be able to work Pacific Time Zone hours.
This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
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.
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) year 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.
- Must be able to pass Criminal Records check upon hire and every three (3) years thereafter.
- Experience working with Medicare, Medicaid or Special Needs populations preferred.
- Medical Assistant, Certified Nursing Assistant, traditional health worker, or community care coordination experience preferred.
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