Job Description

The Clinical Outreach Associate (COA) serves as a liaison between the health plan, healthcare providers and members. The target population COAs will address, are members in need of chronic condition education and care coordination. The goal of the COA is to connect members with the appropriate care related to their chronic condition needs and beyond.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:

· Educates members regarding plan benefits, preventive care, disease management, case management services, resources in the community, care coordination, and value-added services.

· Conduct outreach calls to members and providers by phone and mail in support of Population Health Management, including the promotion of various clinical programs to assist members with their chronic conditions and overall health

· Collaborate with University of Maryland Medical System Health Plan (UMMSHP) employees who are also conducting other outreach initiatives to ensure all opportunities to close gaps in care are addressed.

· Collect and report health and social information while demonstrating multicultural sensitivity and effective communication skills with members.

· Uncover, understand, and address barriers appropriately to ensure members are able to receive and/or comply with the care they need.

· Evaluate the need and complete the transfer to clinical staff for further care, as appropriate.

· Collaborate with members, families, and healthcare providers to enhance patient wellness and facilitate access to care.

· Complete daily tasks and document all activities in the appropriate system(s) in the timely manner.

· Other duties as assigned.

EDUCATION, EXPERIENCE AND QUALIFICATIONS:

· Two to Three (2-3) years of job-related experience providing outreach services for a healthcare provider, health facility, health plan, and/or other related platform

· Education: Associates Degree preferred

· Excellent interpersonal, organizational, writing and computer skills

· Ability to engage beneficiaries, clients, and providers to diffuse difficult situations

· Bilingual a plus

KNOWLEDGE, SKILLS AND ABILITIES:

· Exceptional written and oral communication skills.

· Strong work ethic built on a foundation of proactivity and teamwork.

· Make decisions regarding work processes based on established guidelines.

· Prioritize and organize work to meet changing priorities.

· Knowledge of health education, motivational strategies, and an empathetic manner working with the underserved.

· Demonstrates skills in problem-solving, decision-making, conflict resolution and the ability to set and meet deadlines working independently, as well as on a team.

· A positive attitude, with an ability to work hard in a fast-paced, highly complex and dynamic movement for healthcare reform.

· Even-tempered and able to adjust tasks in accordance with changing priorities.

· Personal and professional record of accomplishment that demonstrates a commitment to quality in healthcare.

· Willingness to “think outside the box”, accept feedback and embrace the challenges a fast-paced work environment.

· Able to maintain professional boundaries with members and coworkers.

· Ability to monitor, review and resolve patient needs including addressing barriers to care.

· Compile, analyze, and organize data and information from multiple sources to carry out assignments.

· Knowledge of Medicaid and Medicare benefits desirable.

COMPUTER SKILLS:

· Proficiency in Microsoft Office, Word, Excel and PowerPoint.

· Familiarity with medical management software utilized for case management.

· Familiarity with Electronic Medical Records