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Member Engagement Specialist

2 months ago

Piqua, Ohio, United States Elevance Health Full time
Position Title: Member Engagement Specialist

Location:
This role is primarily field-based, requiring candidates to be located within the state of Florida.

Work Schedule:
Monday to Friday, with flexible hours between 8 AM and 7 PM EST, including potential weekend shifts as necessary.


The Member Engagement Specialist plays a crucial role in ensuring adherence to member treatment strategies for less complex cases while actively seeking opportunities to enhance member health outcomes and achieve quality objectives.


Key Responsibilities:
  • Facilitates follow-up care requirements for members by organizing appointments or enrolling them in relevant programs.
  • Evaluates member adherence to medical treatment strategies through phone consultations or in-person visits.
  • Identifies obstacles to treatment compliance and coordinates solutions.
  • Recognizes opportunities that influence quality objectives and suggests process enhancements.
  • Proposes modifications to treatment strategies and assesses the need for additional services in collaboration with case management and healthcare providers.
  • Coordinates the identification and referral to local, state, or federally funded initiatives.
  • Guides members on strategies to mitigate health risks.
  • Documents case updates and compliance reports.
  • Establishes and nurtures relationships with relevant agencies as per contractual agreements.

Minimum Qualifications:


High school diploma and at least one year of relevant experience; or a combination of education and experience that provides an equivalent background.


Preferred Qualifications:
  • Experience dealing with complex psychiatric conditions and medical issues is highly desirable.
  • Background in health coaching and motivational interviewing techniques.
  • Experience working in diverse community environments.
  • Bachelor's degree in a related field is preferred.
  • Bilingual proficiency in English and Spanish is advantageous.


For areas accredited by URAC, the following professional competencies are essential: Associates in this position are expected to possess strong oral, written, and interpersonal communication skills, along with problem-solving, facilitation, and analytical abilities.