Case Management, Associate, Patient Engagement

Status: Full-time, Exempt: No         

Summary: 

This position will serve as the first point of contact to members identified for MVP’s Integrated Medical/Behavioral Care Management Programs. As the first point of contact for these programs, the responsibility for efficient, customer service-oriented telephone interface is paramount. The Patient Engagement Specialist will: Lead efforts to locate and engage new and previously hard-to-engage members. This individual works to overcome language and cultural barriers and engages caregivers and/or household members, as applicable. Utilize communication skills such as motivational interviewing to gain agreement from members to participate in the onboarding process; persistently forges trusting relationships and engages individuals not readily interested in such activities. Conduct brief assessments with the members identified and introduce the program and discuss their availability for clinician follow up to address their healthcare needs and concerns. Uses internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful modes of communication with unreachable or hard-to-reach members. Provides education to new members regarding Integrated Medical/Behavioral Care Management Programs and the role of the Care Manager. Utilizes established workflows and collaborates with internal & external stakeholders such as: Member Services, Care Managers, Enrollment, Population Health Managers, Value Based Care Partners. Complete other processes including producing and sending system-generated correspondence to members, contacting physician practices for medical information, and other tasks as assigned by management. The qualified candidate will have the skills needed to engage with the population, appropriately document throughout assessment process, and schedule additional outreach per process or as assigned. All information regarding the contacts are entered into our care management system. The Patient Engagement Specialist strictly maintains the confidentiality of our member and provider information.

POSITION QUALIFICATIONS

Minimum Education:

High School diploma or equivalent education

Minimum Experience:

At least 2 years relevant health insurance, medical/behavioral healthcare, call center or claims experience with at least one-year managed care experience preferred.

Required Skills:

• Excellent client service/telephone skills and ability to deal with stressful phone calls in a calm and diplomatic manner;

• Excellent computer skills including working knowledge of Microsoft Office, Word
and Excel and the internet

• Familiarity with medical terminology

• Strong written and verbal communication skills

• Experience in positions requiring strict adherence to confidentiality