Job description

Position: Member Education Specialist
Location: Remote
Duration: 12+ months contract position with strong possibility of extension
Shift timing: Monday to Friday 8.30 am-5 pm

Job Description:

Responsibilities:
The position is accountable to provide member education and outreach which includes, but is not limited to,
general health education on key objectives (childhood, adolescent and adult development skills and needs)
as well as chronic disease prevention and education on specific HEDIS measures with an emphasis on
scheduling appointments for needed services.

Conduct outbound educational telephone calls regarding available benefits, services and
programs as well as complete health needs assessments and refer members to Population
Health Programs as needed,
Encourage and motivate members to become compliant by scheduling appointments and
coordinating the needed appointments with provider offices
Be familiar with provider locations and specialties to ensure access to services
Coordinate transportation to and from appointments when necessary
Treat customers in a courteous, friendly tone and professional manner
Listen intently to customer’s needs and concerns
Be knowledgeable of member materials (written, website, and Facebook) and order materials
when necessary
Be knowledgeable of HEDIS measures, claims billing guidelines and health plan standards
Utilize member engagement techniques and offer incentives as applicable
Utilize systems such as Facets, CareCommunications Management Systems (CCMS) and
Care Advance (CA)
Manage CCMS call que daily to ensure timely completion of tasks due to the specificity of
timeframes for certain call types (for example: prenatal, postpartum, immunizations,
appointment reminders and follow-ups)
Educate members on available community resources as necessary
Be aware of physical and behavioral trauma triggers and act to engage appropriate staff
Assist with inbound customer service lines and/or work overtime as needed

Education
High School Diploma or equivalent required

Experience
Customer Service experience preferred.
Medicaid experience preferred.

Skills/Certifications
Microsoft Office products knowledge desired
Effective oral communication and interpersonal skills
Good written communication skills
Good organizational and time management skills
Sound decision-making and problem solving skills
Typing test will be given.

Job Type: Contract

Salary: $17.00 per hour

Schedule:

• 8 hour shift

Education:

• High school or equivalent (Preferred)

Experience:

• Customer service: 2 years (Preferred)
• HEDIS: 1 year (Preferred)
• Medicaid: 1 year (Preferred)

Work Location: Hybrid remote in Chattanooga, TN 37402

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