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Customer Outreach Advocate

2 months ago

Houston, United States Harris Health System Full time

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

- Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
- Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
- Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
- Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

**Skills / Requirements**:
**JOB SPECIFICATIONS AND CORE COMPETENCIES**:

- Essential Functions_
- 25% Performs outreach calls to support Member and Provider campaigns for a wide variety of inquiries and assistance involving benefits, claims, medical appointments/transportation and more.
- 25% Educates, assists and coordinates health services for members through effective communications on inbound and outbound calls
- 25% Completes ad-hoc requests to ensure the safety of environment and well-being of our membership in support of Outreach affairs
- 10% Demonstrates effective telephone skills
- 15% Demonstrates effective customer service skills
- Marginal Functions_
Utilizes time effectively

Reports to Position Title: Customer Engagement Supervisor
Employees Supervised Titles: N/A

**MINIMUM QUALIFICATIONS**:

- Education/Specialized Training/Licensure: High School diploma or GED or equivalent
- Work Experience (Years and Area): 3 years relevant work experience of which: Two years of experience in health care/plan, call center, customer service, and/or sales.
- Must have CHW certification or obtained within the first 6 months of employment.
- Management Experience (Years and Area): N/A
- Software Proficiencies: Microsoft Office (Word, Excel, Outlook)

**COMPETENCIES**

Job Family/Job Title Competencies
- Customer Oriented
- Attention to Detail
- Listening
- Responding Sensitively
- Writing /Composing

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