Your Future is our Future

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.

Position:

Health Outreach Specialist

Position Summary:

As a Health Outreach Specialist at Essence Healthcare, you’ll play a vital role in connecting with our Medicare members and helping them get the most out of our Case Management Programs. You’ll be a valued member of a supportive, multidisciplinary care team that truly makes a difference in people’s lives.

In this role, you’ll inspire and empower members to take charge of their health by offering thoughtful support and encouragement as they navigate their care journeys. Using your excellent communication skills, you’ll reach out by phone to promote health, coordinate primary care appointments, identify and escalate healthcare needs to the Care Management team, and make friendly reminders that help keep our members on track. You’ll also work closely with other dedicated healthcare professionals to understand each member’s unique needs and ensure they receive the personalized support they deserve.

Job Description:

Primary Responsibilities

• Provides telephonic outreach to members post discharge who were hospitalized with a low-risk diagnosis to offer support and referrals to internal and external resources as appropriate.
• Impacts member satisfaction by serving as a liaison to the plan, connecting members to resources and other departments
• Reaches out to members and engages them in a discussion around case management program benefits and enrollment.
• Initiates referrals into identified case management programs (i.e., Transitional Care Program, Complex Case Management).
• Maintains daily calling schedule and caseload.
• Coordinates calls between member and primary care physician office staff to schedule patient appointments and coordinates other activities related to the member's prescribed treatment plan.
• Assists with the coordination, processing and mailing of the translation letters for the department.
• Documents and tracks activities in a business operating system.
• Coordinates and completes special projects as assigned.
• Maintains basic knowledge of plan benefits, services, and changes from year to year.
• Interacts efficiently and effectively with members, providers, internal team members.

Qualifications

• High School degree or equivalent
• 1+ years of medical assistant experience or customer service experience in the medical field or the knowledge, skills, and abilities to succeed in the role
• Strong verbal communication skills
• Experience in working with chronic disease states
• Ability to motivate people to participate in special programs
• Ability to effectively communicate with physician office staff
• Firm organizational and problem-solving skills
• Good interpersonal and customer service skills, including telephone etiquette
• Ability to multi-task and prioritize work
• Adept at learning and using computer systems
• Proficient in Microsoft Word and Excel
• Flexible and adaptive to a changing environment
• Ability to follow through instructions and good attention to detail

Preferred

• Associate's degree in healthcare related field
• Medicare Advantage Health Plan experience
• CNA, LPN, Medical Assistant, or direct health care experience

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

#LI-Remote

Pay Transparency:

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is:

$39,000.00-$48,150.00

Benefits of working at Lumeris

• Medical, Vision and Dental Plans

• Tax-Advantage Savings Accounts (FSA & HSA)

• Life Insurance and Disability Insurance

• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)

• Employee Assistance Program

• 401k with company match

• Employee Resource Groups

• Employee Discount Program

• Learning and Development Opportunities

• And much more...

Be part of a team that is changing healthcare!

Member Facing Position:

Yes- Member or Patient Facing Position

Location:

United States

Time Type:

Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.

Disclaimer:

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.