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Job Description:

Location- The individual needs to reside in the Denver metro area for periodical on-site meeting

The Member Support Specialist is responsible for connecting members and providers with existing health services to effectively navigate and maximize their use of the health system.

Essential Functions:

• Liaises between Health First Colorado members, health systems, medical providers and the CCHA Member Support Services call center in order to navigate the medical home system of care

• Provides customer service for member inquiries, to include answering eligibility and enrollment questions, administering health needs assessments, identifying barriers and presenting solutions, and triaging patients to a higher level of care coordination

• Provides customer service for physical and behavioral health provider inquiries, to include answering questions and connecting providers with available resources across the health system

• Triages incoming care coordination referrals by assessing level of urgency, reviewing and documenting needs

• Meets required inbound and outbound call statistics and documentation requirements

• Develops strong telephonic relationships with members to include educating members on proper use of the health care system, providing and/or arranging appropriate referrals to medical and non-medical services, and completing timely telephonic follow-up

• Participates in team meetings

• Maintains confidentiality and ensures compliance with HIPAA regulations

• Other duties as assigned

Knowledge, Skills and Abilities:

• Excellent verbal and written communication skills

• Great customer service skills

• Teamwork skills

• Independent problem-solving skills

• Self-motivated and self-managed

• Good computer and research skills

• Working knowledge of social determinates of health

• Proficient in Microsoft Office Suite

Qualifications:

·High School Diploma or GED

·1-3 years experience in customer service

·Experience working in a health care setting (Medical Assistant-preferred)

·Bilingual; fluent in English and Spanish (preferred)

·Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures

Salary Range:

$16.83 - $21.04