Job DescriptionProvides ongoing, community-based support for an assigned caseload of health plan enrollees to improve compliance with recommended health services with the designated health care provider. Conducts telephone and in-person communication with enrollees to arrange appointments and transportation, as needed.
- Contacts members through various forms of communication (primarily phone and in-person) to assess whether members are receiving the recommended health services covered by the plan.
- Mitigates barriers such as transportation, locating a doctor to ensure members are obtaining appropriate health care.
- Contacts providers to ensure appointment status.
- Performs in-person visits with members needing additional assistance and motivation in obtaining necessary care.
- Ensures documentation of all member interactions is accounted for in a systematic way.
- Shares experiences with team members for training and program development regularly.
General Job Information
TitleHEDIS Outreach Specialist - Region 5
Job FamilyQuality Group
CountryUnited States of America
FLSA StatusUnited States of America (Non-Exempt)
Recruiting Start Date10/2/2018
Date Requisition Created10/2/2018
License and Certifications - RequiredDL - Driver License, Valid In State - Other
License and Certifications - PreferredLCSW - Licensed Clinical Social Worker - Care Mgmt, LMHC - Licensed Mental Health Counselor - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt
Other Job Requirements
Managed health care, Medicaid and/or behavioral health experience a plus.
Strong written and verbal communication skills. Ability to organize a daily schedule while remaining flexible as member needs may change. Strong work ethic. Flexibility with a new program. Ability to work in a team environment. Ability to work independently.
Community based or home health care experience.
Experience documenting in a clinical record or information system.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
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