Care Engagement Specialist 1 - 210938
Bcforward
Care Engagement Specialist 1 - 210938BC Forward is looking for Care Engagement Specialist 1 (Remote KY)
Position Title: Care Engagement Specialist 1 (Remote KY)
Location: Louisville KY - 40223
Anticipated Start Date: 12/18
Duration: 3 months contract with exension/Temp To hire
Shift: Training is Monday-Friday, 8:30 AM-5:00 PM EST for 2 weeks (with shadowing and cameras on), followed by regular working hours of 8:30 AM-5:00 PM in EST or CST depending on the candidate's location in KY.
Pay Rate: $23.00 /hour (W2)
Need: 1-2 years of outbound call center experience, strong communication skills, proficiency in Excel/Word, ability to lead and educate members while multitasking across systems, knowledgeable in medical terminology, fully conversationally engaged, and capable of completing assessments to close HEDIS care gaps."
Interview Process: 1-Phone/Video Screen, 2-Virtual Round with Panel
Care Navigator
Care Engagement Specialist I
Position Purpose:
Care Engagement is responsible for supporting the organization's goals by obtaining Health Needs Screenings, scheduling preventive service appointments, and educating members on plan benefits and services. The role includes providing members with educational materials and implementing strategies to increase healthcare adherence and reduce barriers to care.
Education & Experience
Required:
High school diploma or equivalent and 3+ years of sales experience in a call center or other high-pressure sales environment, or experience in member, provider, customer service, or call center.
OR
Bachelor's degree in healthcare, business administration, or related field and 1+ year of sales experience in a call center or other high-pressure sales situation, or experience in member, provider, customer service, or call center.
Preferred:
Bilingual in Spanish and English.
Key Responsibilities
Make outbound or receive inbound calls from members to schedule doctor appointments, assist with completion of Health Needs Screenings, or facilitate payments required for enhanced benefits.
Influence members to utilize additional available benefits by educating them on enhanced services and recommending preferred providers.
Educate members on appropriate Emergency Department utilization for non-emergent conditions and explain the impact on their benefits.
Identify and overcome barriers preventing members from completing health screenings, obtaining needed services, or making payments to secure enhanced benefits.
Review each member's profile prior to outreach to identify opportunities, including additional benefits the member may be eligible for.
Participate in continuous quality improvement initiatives to ensure departmental and organizational goals are met and exceeded.
Review and analyze call report data and adjust outreach strategies as needed.
Serve as a secondary resource for the Member Services or Provider Services call centers.
Story Behind the Need
Team Purpose:
We are a telephonic outreach team working with our most vulnerable Medicare members who remain non-compliant with their annual preventive screenings and preventive visits. Work includes outbound member calls (approximately 10 calls per hour) and documenting assessment applications. Proficiency in Excel and Word is required.
Work Environment:
Outbound member-facing calls with occasional provider interaction for appointment scheduling
Supportive team culture with weekly office hours for questions, monthly 1:1s, group chat support, and a resource folder available at all times
Typical Day in the Role
Conduct outreach to an average of 10 members per hour.
Assist members in scheduling provider appointments and addressing open care gaps.
Provide educational information and support related to Social Determinants of Health (SDoH) barriers.
Document interactions while navigating multiple systems simultaneously.
Performance Expectations:
Consistently meet outreach targets
Demonstrate strong conversational and educational abilities
Accurately complete documentation and needed assessments
Candidate Requirements
Education:
Required: High school diploma
Preferred: -
Licensure:
Required: None
Preferred: -
Experience:
1-2 years of outbound call center experience
Proficiency in Excel and Word
Ability to lead conversations with members
Strong verbal and written communication skills
Ability to educate members while documenting across multiple systems
Knowledge of medical terminology preferred
Disqualifiers (Please Note):
Prior roles that were short-term without clarification (state if contract and whether completed)
Over-qualification (e.g., physicians, master's degree)
Claims-based roles
Pharmacy technicians
Inbound-only customer service experience
Top 3 Must-Have Hard Skills
Ability to fully engage with members conversationally while providing support for needed medical care
Ability to work across multiple systems/screens while maintaining active conversation (no dead air)
Ability to complete assessments required to close HEDIS care gaps
Position Title: Care Engagement Specialist 1 (Remote KY)
Location: Louisville KY - 40223
Anticipated Start Date: 12/18
Duration: 3 months contract with exension/Temp To hire
Shift: Training is Monday-Friday, 8:30 AM-5:00 PM EST for 2 weeks (with shadowing and cameras on), followed by regular working hours of 8:30 AM-5:00 PM in EST or CST depending on the candidate's location in KY.
Pay Rate: $23.00 /hour (W2)
Need: 1-2 years of outbound call center experience, strong communication skills, proficiency in Excel/Word, ability to lead and educate members while multitasking across systems, knowledgeable in medical terminology, fully conversationally engaged, and capable of completing assessments to close HEDIS care gaps."
Interview Process: 1-Phone/Video Screen, 2-Virtual Round with Panel
Care Navigator
Care Engagement Specialist I
Position Purpose:
Care Engagement is responsible for supporting the organization's goals by obtaining Health Needs Screenings, scheduling preventive service appointments, and educating members on plan benefits and services. The role includes providing members with educational materials and implementing strategies to increase healthcare adherence and reduce barriers to care.
Education & Experience
Required:
High school diploma or equivalent and 3+ years of sales experience in a call center or other high-pressure sales environment, or experience in member, provider, customer service, or call center.
OR
Bachelor's degree in healthcare, business administration, or related field and 1+ year of sales experience in a call center or other high-pressure sales situation, or experience in member, provider, customer service, or call center.
Preferred:
Bilingual in Spanish and English.
Key Responsibilities
Make outbound or receive inbound calls from members to schedule doctor appointments, assist with completion of Health Needs Screenings, or facilitate payments required for enhanced benefits.
Influence members to utilize additional available benefits by educating them on enhanced services and recommending preferred providers.
Educate members on appropriate Emergency Department utilization for non-emergent conditions and explain the impact on their benefits.
Identify and overcome barriers preventing members from completing health screenings, obtaining needed services, or making payments to secure enhanced benefits.
Review each member's profile prior to outreach to identify opportunities, including additional benefits the member may be eligible for.
Participate in continuous quality improvement initiatives to ensure departmental and organizational goals are met and exceeded.
Review and analyze call report data and adjust outreach strategies as needed.
Serve as a secondary resource for the Member Services or Provider Services call centers.
Story Behind the Need
Team Purpose:
We are a telephonic outreach team working with our most vulnerable Medicare members who remain non-compliant with their annual preventive screenings and preventive visits. Work includes outbound member calls (approximately 10 calls per hour) and documenting assessment applications. Proficiency in Excel and Word is required.
Work Environment:
Outbound member-facing calls with occasional provider interaction for appointment scheduling
Supportive team culture with weekly office hours for questions, monthly 1:1s, group chat support, and a resource folder available at all times
Typical Day in the Role
Conduct outreach to an average of 10 members per hour.
Assist members in scheduling provider appointments and addressing open care gaps.
Provide educational information and support related to Social Determinants of Health (SDoH) barriers.
Document interactions while navigating multiple systems simultaneously.
Performance Expectations:
Consistently meet outreach targets
Demonstrate strong conversational and educational abilities
Accurately complete documentation and needed assessments
Candidate Requirements
Education:
Required: High school diploma
Preferred: -
Licensure:
Required: None
Preferred: -
Experience:
1-2 years of outbound call center experience
Proficiency in Excel and Word
Ability to lead conversations with members
Strong verbal and written communication skills
Ability to educate members while documenting across multiple systems
Knowledge of medical terminology preferred
Disqualifiers (Please Note):
Prior roles that were short-term without clarification (state if contract and whether completed)
Over-qualification (e.g., physicians, master's degree)
Claims-based roles
Pharmacy technicians
Inbound-only customer service experience
Top 3 Must-Have Hard Skills
Ability to fully engage with members conversationally while providing support for needed medical care
Ability to work across multiple systems/screens while maintaining active conversation (no dead air)
Ability to complete assessments required to close HEDIS care gaps
Interested candidates please send resume in Word format Please reference job code 247640 when responding to this ad.
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