Specialist, Local Support

PLS Researcher Job Summary/Objective:   

The Personal Local Support (PLS) Specialist is responsible for the receipt of requests for assistance with local recommendations, investigation of available local providers/resources, and delivery of said recommendations to the member or care team representative.  The PLS team provides concierge services to our members.   

Job duties & responsibilities: 

• Promotes the mission, vision, and values of the organization. 

• Receive requests for member assistance regarding local provider recommendations or community resources. 

• Investigation of requests to identify additional information needed or additional resources that could/should be offered. 

• Research of local providers or resources to evaluate: Insurance network coverage, quality measures, geographic alignment, and alignment with other stated member needs such as language, gender, and availability.  

• Collection and dissemination of pertinent medical records (as needed) to support continuity of care (when applicable).  

• Facilitation of scheduling through sharing of collected information to involved parties, and/or direct assistance with initial appointment scheduling.   

• Member follow-up post recommendation to confirm services rendered were received, resolution of the request, and identification of additional support/resources needed.  

• Phone coverage is 3.50 hours daily and a monthly average of 6.50 hours.  

• Individual KPIs (Key Performance Indicators) for each Researcher: 

• Within 30 days 2  

• Within 60 days 3  

• Within 90 days 4  

• 6 months 182 days >5 

• TAT <4 

• Urgent and VIPs 24 TAT  

• Additional duties as assigned I.e. cross-coverage between departments with transferable skills sets 

• Shift 7-4 or 8-5 based on business needs 

• Rotating holidays/on-call  

 Skills and Qualifications:   

Minimum of 1 – 3 years of experience in a healthcare setting, with at least 1 year of         experience in medical referral services. 

• Medical terminology proficiency 

• Good written and verbal communication 

• Detail-oriented  

• Good critical thinking and prioritization capabilities and the ability to adapt to change. 

• Excellent communication and interpersonal skills, with the ability to interact effectively with members, healthcare providers, and team members. 

• Ability to work independently, prioritize tasks, and manage multiple priorities in a fast-paced environment. 

• Demonstrated commitment to quality, customer service, and continuous improvement. 

• Proficiency in Microsoft Office Suite and other relevant software applications, Computer (Mac & Windows) proficiency. 

Working Conditions: 

Work 2 – 3 days in an office environment (may vary).  

Physical Requirements: 

This position may require sitting or standing for extended periods, as well as some lifting and carrying of supplies or equipment.