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Relationship Establishment Specialist | Victorville
4 months ago
Who we are:
We are a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need. We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.
Join us in our mission
Job Summary: The Relationship Establishment Specialist is responsible for customer service tasks that ensure current and prospective members have the information and assistance they need for the Enhanced Care Management and Health Homes Program.
Essential Functions:
- Conduct in-person and telephonic outreach as needed to comply with ECM guidelines.
- This position will require significant in-person outreach, with an estimated time commitment of 50-80% of working hours spent on fieldwork and face-to-face interactions dependent on County and department needs.
- Meet members where they are during in-person outreach, locations include but are not limited to the members home, apartment, shelter, hospital, facility, etc.
- Follows established policies to outreach, enroll and exclude members.
- Verify eligibility for enrollment in the Enhanced Care Management program (ECM).
- Complete a referral to the ECM program when necessary.
- Conducts appropriate member assessments telephonically and/or in-person.
- Complete necessary documentation and upload to our EMR.
- Responsible for coordinating with individuals and/or entities to ensure a seamless experience for the members and non-duplication of services.
- Partners with healthcare professionals, community and social support services, and other healthcare entities to locate members.
- Communicates and collaborates with Lead Care Managers (LCMs), regarding the members' progress and care needs.
- Identifies, coordinates, and follows-up on member referrals to ensure continuity of care, and member needs are being met.
- Investigates and directs member inquiries or complaints to appropriate staff members and follows up to ensure satisfactory resolution.
- Follows established protocol around patients experiencing pain, safety concerns and/or mental health concerns and creates safety plans, if necessary.
- Recognizes signs of child and elder abuse and reports appropriately to Child/Adult Protective Services.
- Understands and abides by all departmental and companywide policies and procedures.
- Complies with all safety and injury prevention policies and regulations.
- Performs other duties as assigned or required.
Position Requirements:
- 1 year of experience in healthcare or social service
- Language: Fluent in English and Spanish (written and verbal).
- License/Certification: Current and valid Driver’s License and proof of auto insurance.
- Skills required: Competent with computers, email, virtual platforms, MS Excel, MS Word, MS PowerPoint, MS Outlook, and other Microsoft Office-based programs.
- Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear, effective manner.
- Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures.
- Ability to stand/walk for long periods of time
- Ability to lift/carry 10lbs
Preferences (not a requirement for the role):
- Education & Experience: High School Diploma
- +1 year of experience as an outbound call center representative.
- An equivalent combination of education and experience that provides the skills, knowledge, and ability to perform the essential job duties, and which meets any required state or federal certification requirements.
- Proficiency in EMR system
Benefits:
- This is a hybrid role working from home while still servicing members in person
- Medical, Dental and Vision Insurance
- We cover up to 100% of your premium and 50% of your dependent premium depending on the plan.
- Flexible Spending Accounts, Health Savings Accounts & Dependent Care Accounts are also available.
- Life, AD&D and Short-Term Disability Insurance funded 100% by Titanium Healthcare
- 401(k) plan
- Employee Assistance Program
- 12 Paid Holidays, 3 weeks of all-inclusive PTO per year (accrual begins on the first day of employment) as well as a separate Paid Sick Time balance
