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Member Outreach Representative (Tues - Sat) - Welcome Wagon

Company: Optum
Location: Tacoma
Posted on: January 16, 2022

Job Description:

Position Summary:Our Welcome Wagon program welcomes new seniors with compassion and respect by ensuring each new senior is positioned for long-term wellness. The Welcome Wagon Member Outreach Representative's (MOR) primary responsibility is to ensure new members are welcomed, introduced to Optum, and support member retention through telephonic engagement. The MOR establishes first contact with new members. During the call, the MOR support will support care coordination, capture communication preferences, identifies common barriers to retention and educates member on Optum services. MORs facilitate and share relevant business offerings and programs with members and their caregivers.Alt. Work Hours Schedule: Teammates will work an alternative schedule equivalent to 40 hours/week.Option 1

  • 4 Weekdays 10am - 6pm
  • Saturday 9am - 1pmOption 2
    • 4 Weekdays 9:30am - 6:30pm or 10am - 7pm
    • Saturdays 8am - 4:30pmResponsibilities:
      • Responsible for outbound calls to all new senior members and scheduling Welcome Wagon visits
      • Responsible for educating members on how to access their health plan benefits
      • Responsible for conducting pre-Welcome Wagon visits assessments for our members
      • Responsible for conducting Welcome Wagon appointment reminder calls the day prior
      • Respond to and resolve on the first call, member service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
      • Help guide and educate members about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well-being by selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider
      • Intervene with care providers (doctor's offices) on behalf of the member to assist with appointment scheduling or connections with internal specialists for assistance when needed
      • Assist members in navigating their payer's network, services, benefits, websites, tools, & apps to encourage and enable members to become self-sufficient
      • Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
      • Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues
      • Provide education and status on previously submitted pre-authorizations or pre-determination requests
      • Meet the performance goals established for the position in the areas of: efficiency, call quality, member satisfaction, first call resolution and attendance
      • Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
      • Other duties as assignedRequired Qualifications:
        • 1 year of experience with Healthcare claims, benefits, and/or authorizations (i.e. in a doctor's office, HMO, etc.)
        • MUST be bilingual English/Spanish to be considered for this position
        • Able and willing to adjust daily schedule and work over-time and/or weekends, as neededPreferred Qualifications:
          • High school diploma, GED, or equivalent
          • 1-year experience in call center making outbound callsSoft Skills:
            • Demonstrates ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member
            • Proficient problem-solving approach to quickly assess current state and formulate recommendations
            • Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions members can understand and act upon
            • Flexibility to customize approach to meet all types of member communication styles and personalities
            • Proficient conflict management skills to including ability to resolve issues in a stressful situation and demonstrating personal resilience
            • Ability to proactively identify member needs and meet themReports To: Welcome Wagon Supervisor

Keywords: Optum, Tacoma , Member Outreach Representative (Tues - Sat) - Welcome Wagon, Other , Tacoma, Washington

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