GENERAL SUMMARY
Makes outreach calls to identified members to provide proactive information to educate and encourage them to participate in specialized programs to better manage their health. Ensures members are enrolled in all appropriate programs. Works closely with Clinical Health Manager, patient, physician, and case management staff to achieve established program outcomes.
ESSENTIAL RESPONSIBILITIES
- Provides support to the Clinical Health Manager and case management staff by providing outreach to members to educate them and encourage them to enroll in all appropriate programs provided by their health plan benefits to achieve established outcomes.
- Schedules follow-up meetings and/or teleconferences between member and Clinical Health Manager as appropriate. Coordinates calls between nurse, physician, and member to coordinate activities related to the members’ prescribed treatment plan.
- Investigates and responds to member inquiries via personal contact, telephone, and in writing regarding plan usage. Ensures that expectations of both members and providers are continuously met to ensure problems are presented and addressed as they occur for immediate resolution.
- Collects and analyzes program enrollment data. Tracks and reports member de-enrollment requests. Prepares reports that identify and interpret trends to assist marketing in member retention activities.
- Oversees the preparation of individual and group mailings for new and prospective members.
- Performs other duties as assigned.
Qualifications:
JOB SPECIFICATIONS
- High school degree or equivalent. Bachelor’s degree preferred.
- Previous (2-5 years) customer service, marketing, or equivalent experience.
- Ability to motivate people to participate in special programs.
- Ability to work independently.
- Strong analytical and problem solving skills.
- Demonstrated verbal and written communication skills.
- Ability to effectively handle multiple tasks.
- Proficient use of standard corporate word processing and spreadsheet software packages.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: St. Louis, MO, US
Organization: 10000 - Coventry Health Care - Corp
Schedule: Full-time
Job Posting: 2013-01-31 00:00:00.0
Job ID: 1310418