Member Support Specialist - Full Time & Work at Home!

Southwest
Immediate

Job Description

Innovative, Dynamic, Fast Pace and Collaborative, these are just some of the words that our employees use to describe us but hey - don’t just take it from us - become a part of BroadPath today and experience our Culture of Constant Connection! At BroadPath we strive to transform the modern workplace by embracing the spirit of revolution coupled with advanced technology to create an experience out of every day. BroadPath is excited to be hiring Member Support Specialist! The Member Support Specialist will work as an integral part of the case management team to serve as a resource to members. The Specialist will work telephonically and in person to support members with complex psycho-social issues which create barriers to adherence with medical regimens and achievement of optimal health outcomes. (Examples may include activities such as assisting with arranging transportation, linking patients with community resources, etc.). Will assist with program development and build effective member and provider relationships. Will be required to do lots of documentation and research.

Responsibilities

Essential Responsibilities
  • In coordination with the member’s case manager, develop and implement goals and/or plans tailored to assist members in navigating the complexities of the healthcare system
  • Educate members on understanding and working within the parameters of their benefit structure
  • Utilize motivational interviewing and patient-engagement techniques to support members in achieving optimal health outcomes by effectively utilizing their benefits
  • Serve as liaison between members and providers/agencies
  • Identify members for coordination and case management services through a variety of methods, including claims data and reports
  • Screen requests to identify appropriate referrals to case management from multiple internal and external sources
  • Work collaboratively with the case management team to help facilitate case management process
  • Ensure compliance with applicable state and federal regulations and guidelines in day-to[1]day activities, including maintaining HIPAA standards and confidentiality of protected health information
  • Assist members with referrals, scheduling appointments and ensuring transportation to medical appointments is available
  • Assist members with non-clinical needs for transitions and different phases of care
Supporting Responsibilities
  • Assist with the development of departmental procedures, reports and projects
  • Assist care management to meet quality measures as outlined by government regulations
  • Enter and collate data: prepare reports as assigned
  • Participate in team, department, company, and community-related committees as requested
  • Make presentations to small groups. Actively participates in quality improvement initiatives
  • Meet department and company performance and attendance expectations
  • Perform other duties as assigned

Basic Qualifications

  • A minimum of three years of experience in community services or healthcare agencies focused on coordination services require
  • Education, Certificates, Licenses: High school diploma or acceptable alternative
 
Knowledge
  • Medical terminology
  • Proficient in Microsoft Office, including Word, Excel, PowerPoint, Excellent verbal and written communication skills and is able to work independently as well as to work effectively on a team
  • Good working knowledge of how to access community resources and healthcare system

Preferred Qualifications

Systems/ Experience Preferred:
  • Medical management software (e.g CaseTrakker Dynamo) preferred
  • Insurance industry experience preferred
  • Experience in health insurance and delivering group presentations preferred