Position Summary The Call Center Coordinator is responsible for telephonic outreach and screening of identified members based on plan stratification for care management with a call center approach. Call Center staff also monitor for incoming calls, process referrals, and assist with any questions or needs identified. An experienced and energetic communicator, the coordinator is focused on deepening program participation as well as making members aware of CCNC (plan) programs and offerings.
The Call Center Coordinator interacts with members, providers, and other staff to initiate program interventions, document activities, and refer risk appropriate members to professional staff according to protocols. The candidate for this position must have a disposition towards good customer service, be assertive without being aggressive, and always maintain a professional demeanor.
The Call Center Coordinator will work remotely to cover needs across the state.
Essential Functions - Conduct continual telephonic outreach to identified and referred members focused on engaging members with care management services.
- Receive/retrieve and manage referrals from callers and/or data reports, linking members with care management needs as identified.
- Complete and document member screenings tools and refer clinical needs to most appropriate clinical care management team member for assessment and follow up.
- Verify demographic information.
- Send educational materials, welcome letters, and/or other resources to members, as necessary.
- Assist to identify and address Social Determinant of Health needs.
- Assist with guidance in scheduling medical appointments and transportation as needed.
- Provide information on community resources.
- Assist member with care coordination of resource needs and health care system navigation.
- Provide culturally appropriate general education and information.
- Meet monthly productivity and role expectations.
- Complete all assignments within expected timeframes.
- Perform other duties that assist in keeping the operations organized and functioning as needed.
- Notify supervisor promptly of any issues with receiving or sending referrals, making timely care management assignments, or issues with carrying out any other duties assigned.
- Collaborate with the Care Team to address barriers and create efficiencies with processes
- Abide by department guidelines, company policies, and HIPAA regulations.
- Attend departmental and corporate meetings.
- Understand and uphold CCNC goals, objectives, and standards.
- Perform all other duties as requested.
Qualifications - High School/GED
- Prior telephonic call center experience desired
- Minimum of two years previous work experience, preferably in a healthcare setting
- Healthcare experience and medical terminology knowledge highly preferred
- Bilingual preferred
- Managed care experience a plus
Knowledge, Skills, and Abilities - Computer skills required including various office software and the internet; experience with MS Office software preferred
- Strong initiative and attention to detail
- Performance metric driven and productivity mindset
- Strong oral and written communication proficiency
- Organizational and time management skills
- Strong interpersonal and critical thinking skills; team-oriented
- Resourceful - able to shift strategy or approach in response to the demands of a situation
- Adaptable - responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
- Motivational interviewing skills
- Knowledge of Care Management principles
- Ability to work independently, multi-task, and to use sound judgment when needed
- Outgoing and energetic attitude; respectful customer service skills
- Ability to provide information in a manner that is culturally and linguistically appropriate
- Knowledge of and experience working in member or clinical data systems
Working Conditions - Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time
- Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices
- Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds
- Hands-on clinical treatment is not permitted when performing duties for the organization
- The job environment is a home environment
- Travel using personal vehicle may be required within the region and/or the state
- The job environment can be intense as high volume, repetitive work is an expectation