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Health Support Specialist
3 months ago
Blue Cross and Blue Shield of Vermont is looking for a Health Support Specialist to join our Integrated Health team. Our company is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced and flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401K, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.
REMOTE WORK: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. We're also open to fully remote candidates from Vermont who live further than 50 miles from our Berlin, VT office.
POSITION SUMMARY
The Health Support Specialist is responsible for delivering an outstanding member experience and for maintaining positive relationships with providers and other partners who work with Blue Cross Vermont to support our members as they pursue better health and wellness. The Health Support Specialist works with all levels of expertise, from provider admission clerks to provider business managers, other BCBS Plans, representatives from our client groups, internal front-line and managerial staff, as well as our members and their families.
HEALTH SUPPORT SPECIALIST RESPONSIBILITIES:
- Perform the primary functions of outreach and enrollment for Integrated Health programs, such as:
- Create care enrollments in our documentation system
- Manage multiple ingests and queues of referrals and requests for programs
- Triage cases to evaluate member needs including case research utilizing multiple systems, and following case management guidelines
- Engage in cold-call member outreach
- Screen members for medical and behavioral health needs
- Support brief member requests and care coordination
- Complete and enter health assessments
- Document clearly and concisely in screening tool and notes
- Use critical thinking to determine member support needs
- Identify proper distribution of cases throughout the department and company, as needs arise
- Demonstrate a commitment to integrated, multi-disciplinary practice by working collaboratively with colleagues (internal and external), members, families, and providers throughout the case management process. Practice ongoing supportive research, coordination activities, follow-up calls and administration of screenings and surveys as needed throughout the entirety of an open case to streamline support and care for the member.
- Participate in department and organization-wide initiatives to enhance member health and wellness, improve the quality of care, and generate cost-savings for our customers.
- Identify and refer members for all IH programs based on appropriate referral triggers, including auto triggers, high dollar lists, and predictive modeling reports.
- Identify and maintain an internal reference tool of up-to-date community resources and services that the IH team can use to best serve members.
- Demonstrate a high level of professional and service excellence in all interactions, internal and external, focusing on the development of strong, collaborative relationships.
- Demonstrate an in-depth working knowledge and understanding of departmental policies, procedures, and workflows; identify possible improvements and/or revisions.
- Adhere to program, departmental, and organizational performance metrics and targets that drive productivity, service, clinical, quality, regulatory, and financial objectives.
- Demonstrate continued learning and professional development by attending in-service and other training that addresses the relevant population served, and any mandatory training.
HEALTH SUPPORT SPECIALIST QUALIFICATIONS:
- Associate’s degree or equivalent experience in a related health care field preferred.
- 3-5 years’ experience in a health care setting required, including experience in a similar member- or patient-facing outreach and coordination role.
- Proficient in Excel and MS Word
- Prior experience in a member-facing role in a health plan preferred.
- Certification or licensure in a clinical field a plus.
HEALTH SUPPORT SPECIALIST BENEFITS:
- Health insurance (including vision)
- Dental coverage (free to employees)
- Wellness Program
- 401(k) with employer match + automatic employer contribution
- Life Insurance
- Disability Insurance
- Combined time off (CTO) – 20 days per year + 9 paid holidays
- Tuition Reimbursement
- Student Loan Repayment
- Dependent Caregiver Benefits
