Ready to help us transform healthcare? Bring your true colors to blue.
The Role
As an HHIT Member Engagement Specialist, you will be responsible for connecting with members, scheduling appointments, and referring to care management—all to achieve the best possible member health outcomes.
You will leverage strong flexibility and collaboration skills, along with targeted approaches to connect with members in a timely manner to achieve the highest possible ratings from NCQA and CMS STARs. This position requires the ability to change priorities and processes frequently to support team initiatives, including medical chart reviews and performance measurement and improvement programs.
The Team
As an integral part of the HEDIS HOS Intervention team (HHIT) within Clinical Quality and Compliance, you will coordinate and collaborate with teams and associates inside and outside of HMM, including Care Management, Member and Provider Service, and Performance Measurement and Improvement.
This position is eligible for the following persona: eWorker.
Your Day to Day:
Make outreach calls to members with gaps in care to assure adherence with HEDIS/STARs measures and contact provider offices to schedule appointments as needed. Escalate members to the HHIT Staff when clinical discussion is needed
Providing support of RN Provided Screening programs by scheduling and confirming patient appointments, documentation and faxing providers and other support functions as needed
Assist with non-clinical support needs from HHIT Staff including, but not limited to assisting members MyBlue registration, explaining gap related benefits and how to access benefits
Process faxed outreaches to providers by calling offices to confirm current patient status, obtaining fax number, sending fax and ensuring receipt of fax
Identify member barriers to obtaining care, promote appropriate resources, and make necessary referrals both internally and externally, to mitigate barriers
Ensure timely and clinically appropriate documentation in all required systems and meet daily productivity goals
Participate with Performance Measurement and Improvement in activities such as medical record reviews and provider outreaches
Provide onsite and virtual administrative support to the HHIT and Clinical Quality Team and for any associated improvement events (ex. Screening/Member events) as identified by Senior Manager
We’re Looking for:
Excellent organization, communication, technical, customer service, and problem-solving skills
Knowledge of medical terminology, clinical data, and medical records
Ability to engage and obtain specific clinical information from members in a timely manner, to meet productivity while also serving our members’ needs
What You Bring :
Medical Assistant, Certified Pharmacy Technician, or equivalent health profession experience required
Prior experience with seniors/Medicare members preferred
Experience with clinical telephonic health coaching/call center preferred
#LI-REMOTE
Minimum Education Requirements:
High school degree or equivalent required unless otherwise noted above
Location Hingham Time Type Full time
Hourly Range: $29.82 - $36.44
The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.
This job is also eligible for variable pay.
We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
WHY Blue Cross Blue Shield of MA?
We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.
As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue.
At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our " How We Work " Page.
