Quality Outreach Coordinator

Our Client, a Health Insurance company, is looking for a Quality Outreach Coordinator for their Hopewell, NJ location.

Responsibilities:

Receives incoming calls from members emanating from quality outreach initiatives such as mailings, emails, phone calls, etc. Makes outgoing calls to educate members on the importance of closing gaps in care such as appropriate testing, periodical checkups, immunizations, counseling and provide health education materials. Maintain accurate member records from outreaches such as incoming calls, successful outreaches, member issues, and member roadblocks. Act as a liaison with providers, members and outside community resources by assisting with scheduling an appointment, warm transfers to member services, etc. Assure understanding level of each member by providing clear and complete information in accordance with company guidelines. Administer Rewards and Incentive programs for both Medicaid and Medicare members by sending out rewards, confirm member demographics, and educate members in regard to the R&I Program. Refer members to a Clinical Quality nurses as necessary.

Requirements:

Associates degree from an accredited college or university, preferably in healthcare field; In lieu of degree applicant must have 3 years of equivalent and relevant work experience. 2 years work experience in case management, community health, Medicaid or health insurance environment. Minimum of 2 years experience working with members to close gaps in care. Minimum of 1 year managed care experience. Knowledge of the Managed Care or Health Insurance Industry. Knowledge of medical terminology. Knowledge of PC's and windows based software applications. Knowledge of Medicaid and Medicare regulations. Excellent verbal and written communication skills. Excellent service quality skills. Excellent organizational and interpersonal skills. Good decision making skills. Good problem solving/conflict resolution skills. Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint); Knowledgeable in the use of intranet and internet applications. Why Should You Apply? Health Benefits Referral Program Excellent growth and advancement opportunities #mcb #alljobs