Are you a seasoned Member Liaison seeking fresh challenges? Do you prioritize care management and excel in quality improvement? Are you driven, dynamic, and eager to join a great team? If yes, you could be our next valued addition!
Summary Qualifications:
The Member Liaison acts as a bridge connecting members, contract customers, and providers, facilitating the transition of FFS members to MCOs or vice versa. They field inquiries from contract customers or their constituents regarding members’ transitions, ensuring smooth continuity of care. Additionally, they coordinate with other vendors contracted by the customer, such as transportation and pharmacy services, to streamline activities.
Accountabilities:
- Foster clear communication among staff, providers, and members to address business objectives and fulfill member requirements effectively.
- Document all member and provider interactions meticulously within designated computer systems to facilitate data collection and maintain accurate records.
- Ensure smooth transitions of care and collaborate with other contract customer vendors, such as transportation and pharmacy services, to synchronize activities seamlessly.
- Address inquiries from contract customers or their constituents, including members and providers, regarding upcoming member transitions with prompt and accurate responses.
Knowledge, Skills, Abilities:
- Proficient in reviewing and analyzing documentation against established standards.
- Demonstrates a sense of urgency in meeting deadlines promptly and effectively.
- Upholds confidentiality standards and ensures compliance with HIPAA regulations when handling sensitive issues.
- Possesses knowledge of adult learning principles to enhance training and development initiatives.
- Familiar with various computer applications and adept at navigating through multiple screens efficiently.
- Understands training or workplace learning methodology to facilitate effective knowledge transfer and skill development.
Experience:
- Minimum of 1 year of experience in Community Outreach or Customer Service roles.
- Previous experience in member outreach within the healthcare sector.
- Preferred experience in Medicaid customer service.
Required Qualifications:
- High School Diploma or GED
- Associates or Bachelor’s Degree preferred
The mental and physical demands outlined below are necessary for the successful execution of this role. Reasonable accommodations will be provided in accordance with applicable laws to enable individuals with disabilities to perform the essential functions of the job. While fulfilling job responsibilities, the employee will:
- Sit for extended periods.
- Use keyboards and other tools requiring dexterity.
- Engage extensively with both internal and external stakeholders.
- Occasionally lift and/or maneuver objects weighing up to 10 pounds.
- Periodically travel within the state.