Outreach Representative
Highmark Health, Hartford, CT, United States
Job Summary
This position serves as a liaison between the member, the Health Plan, and relevant state and/or federal regulators. The role provides telephonic support to assess member needs, schedules appointments, educates members about their rights and responsibilities, assists members in navigating the grievance and appeals process, and represents member interests internally and externally.
Essential Responsibilities
Communicate effectively with staff, providers, and members to accomplish business and member needs.
Initiate outreach efforts, primarily by telephone, related to targeted preventive health initiatives.
Perform member education on the importance of targeted preventive health services.
Recruit, holistically assess, and enroll members into Disease Management Programs as appropriate.
Assess opportunities for Care Management intervention and make appropriate referrals.
Contact members, providers, and community agencies to coordinate access to preventive health services.
Track all member and provider contacts in the appropriate computer systems for data collection and record keeping.
Participate in the development of outreach programs that are effective, measurable, and innovative, with a special emphasis on reaching at‑risk members.
Other duties as assigned or requested.
Education
High School / GED
Preferred Education
Associate’s Degree
Experience
1 year in Community Outreach or Customer Service
Preferred Experience
Familiarity with healthcare and/or insurance.
Experience working with the Medicaid and/or Medicare population.
Licenses or Certifications
None
Preferred Licenses or Certifications
None
Skills
Proactive, self‑directed, assertive, and creative in problem solving and system planning.
Strong active listening skills and sensitivity toward diverse people and situations; ability to interact with external customers, peers, colleagues, and management.
Effective time management, prioritization, and multitasking.
Sound judgment and discretion when approaching problems and making decisions.
Ability to utilize flexible productive work habits to set priorities, organize work, and utilize time effectively.
Awareness of issues members face related to healthcare, including transportation, childcare, lack of knowledge about preventive health, distrust of the system, and other personal, social, or financial barriers.
Patience and empathy when interacting with members and all internal/external customers.
Ability to work independently and as a team member.
Language (Other than English) None
Travel Requirement 0% – 25%
Physical and Mental Demands
Position Type: Office‑based
Teaches / trains others regularly – Occasionally
Travel regularly from the office to various work sites or from site‑to‑site – Rarely
Works primarily out‑of‑the office selling products/services – Never
Physical work site required – Yes
Lifting: up to 10 pounds – Constantly
Lifting: 10 to 25 pounds – Occasionally
Lifting: 25 to 50 pounds – Never
Compensation Pay Range Minimum: $19.66
Pay Range Maximum: $27.42
EEO Statement Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J280097
#J-18808-Ljbffr
Essential Responsibilities
Communicate effectively with staff, providers, and members to accomplish business and member needs.
Initiate outreach efforts, primarily by telephone, related to targeted preventive health initiatives.
Perform member education on the importance of targeted preventive health services.
Recruit, holistically assess, and enroll members into Disease Management Programs as appropriate.
Assess opportunities for Care Management intervention and make appropriate referrals.
Contact members, providers, and community agencies to coordinate access to preventive health services.
Track all member and provider contacts in the appropriate computer systems for data collection and record keeping.
Participate in the development of outreach programs that are effective, measurable, and innovative, with a special emphasis on reaching at‑risk members.
Other duties as assigned or requested.
Education
High School / GED
Preferred Education
Associate’s Degree
Experience
1 year in Community Outreach or Customer Service
Preferred Experience
Familiarity with healthcare and/or insurance.
Experience working with the Medicaid and/or Medicare population.
Licenses or Certifications
None
Preferred Licenses or Certifications
None
Skills
Proactive, self‑directed, assertive, and creative in problem solving and system planning.
Strong active listening skills and sensitivity toward diverse people and situations; ability to interact with external customers, peers, colleagues, and management.
Effective time management, prioritization, and multitasking.
Sound judgment and discretion when approaching problems and making decisions.
Ability to utilize flexible productive work habits to set priorities, organize work, and utilize time effectively.
Awareness of issues members face related to healthcare, including transportation, childcare, lack of knowledge about preventive health, distrust of the system, and other personal, social, or financial barriers.
Patience and empathy when interacting with members and all internal/external customers.
Ability to work independently and as a team member.
Language (Other than English) None
Travel Requirement 0% – 25%
Physical and Mental Demands
Position Type: Office‑based
Teaches / trains others regularly – Occasionally
Travel regularly from the office to various work sites or from site‑to‑site – Rarely
Works primarily out‑of‑the office selling products/services – Never
Physical work site required – Yes
Lifting: up to 10 pounds – Constantly
Lifting: 10 to 25 pounds – Occasionally
Lifting: 25 to 50 pounds – Never
Compensation Pay Range Minimum: $19.66
Pay Range Maximum: $27.42
EEO Statement Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J280097
#J-18808-Ljbffr