Job Summary:
The Onboarding Specialist is the primary contact for members as they transition to a CCA health plan. The Specialist contacts new members via telephonic outreach and identifies both the member's existing healthcare services that will continue and new service requests. The Specialist works to ensure that member needs are addressed through liaising with internal CCA providers and external healthcare providers. The Specialist also educates the member on health plan offerings and addresses members' questions or concerns.
Essential Functions:
- Serves as the primary member contact and advocate until their care team is established, both through direct member outreach and inbound call support
- Leverages internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful contact information for unreachable or hard-to-reach members
- Orients new members to the value of CCA as their health plan, providing education, answering members’ questions, anticipating, and meeting member needs and concerns
- Documents members’ current healthcare services and new service requests
- Ensures members continue to receive current healthcare services as they transition to CCA through healthcare provider outreach and education
- Schedules new members’ initial nurse intake visits
- Utilizes communication skills such as motivational interviewing to gain agreement from members to participate in the onboarding process, persistently forging trusting relationships and engaging individuals not readily interested in connecting with CCA
- Utilizes established workflows and collaborates with internal and external stakeholders and healthcare providers
- Provide clinical care to members via telehealth technologies (video, chat, etc.) for a clinically appropriate clinical care and care management services.
- Perform any other job related duties as requested.
Education and Experience:
- Bachelor's Degree or relevant experience in call center and/or Medicare/Medicaid plan required
- Equivalent years of relevant work experience may be accepted in lieu of required education
- Five (5) years of relevant experience required
- One (1) year working in outreach or in the community with individuals who have behavioral, medical, social, or interpersonal complexities impacting their lives required
- Experience working in a multi-cultural setting required
- Experience using motivational interviewing techniques in a professional setting required
- Experience identifying unmet healthcare needs and escalating to the appropriate individual preferred preferred
- Experience with electronic medical record and care management systems strongly preferred preferred
Competencies, Knowledge and Skills:
- Demonstrated understanding of the community served
- Familiarity with data entry and querying databases to identify key information about members
- Excellent communication skills, including the ability to convey information clearly telephonically and in a culturally sensitive manner
- Strong interpersonal and customer relation skills, including active listening skills, dependability, and responsiveness
- Compassionate, understanding, and patience
- Motivates, empowers, inspires, and collaborates with members while effectively establishing boundaries by clarifying roles, expectations, and deliverables
- Ability to develop and maintain positive working relationships with peers, supervisors, and other organizations
- Knowledge of some medical terminology preferred
- Ability to multitask and ensure all work is completed thoroughly and completely in a fast-paced environment with competing demands
- Basic computer skills
- Professional, comprehensive, clear documentation
- Familiarity with Microsoft Office programs: Outlook, Calendar, Word
- Willing to learn and utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services.
Licensure and Certification:
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
- Travel is not typically required
Compensation Range:
$47,400.00 - $76,000.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
HourlyOrganization Level Competencies
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
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What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits. CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve. CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación. 如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码







