Member Engagement Specialist

This position is remote in Washington State only

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to apply an equity lens to all our work. 
• Reduce health disparities. 
• Become an anti-racist organization. 
• Create an equitable work environment. 

About the Role

Provides technical and administrative support to the case management team.  Conducts member outreach to encourage and facilitate enrollment in the Case Management program.

To be successful in this role, you:

• Have three (3) years in administrative, customer service, and/or patient services coordination (referrals, appointments, etc.) in a healthcare services field, required.
• Have one (1) year as a Medical Assistant or related field, required.
• Have a certification through an accredited medical assistant program, Allied Health education program, or other related certification, preferred.

Essential functions and Roles and Responsibilities:

• Assists with intake of new members, and informs potential members of the services available to them.
• Provides telephonic triage of inbound member, family, and/or caregiver calls; triages to appropriate staff, or resolves issues directly.
• Provides educational material as directed by case manager.
• Schedules outreach calls; maintains and verifies member contact information in Jiva.
• Alert case managers of new case management referrals
• Serves as a liaison between providers, vendors and the member and/or member’s representative as needed.
• Uploads medical documentation as directed. Ensures all case coordination activities are included in the medical record system per established guidelines.
• Works with other departments to resolve member provider issues; notify management of outcomes.
• Assist with various administrative tasks, including discharge preparations, request/collection of clinical information, provider authorizations as directed.
• Prioritize, organize, and complete daily work both independently.
• Reporting to work on time and for all scheduled shifts is essential to this position.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

• Ability to speak Spanish preferred.
• Knowledge of medical terminology, electronic medical records, and healthcare process preferred.
• Effective verbal and written communication skills.
• Demonstrated organizational and time management skills.
• Demonstrated proficiency and experience with Microsoft Office products.
• Ability to work independently.

Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn’t perfectly check every box in the job description, we encourage you to apply anyway.

As part of our hiring process, the following criteria must be met:

• Complete and successfully pass a criminal background check.

Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
• Vaccination requirement (CHPW offers a process for medical or religious exemptions)
• Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Non-Exempt and is eligible for overtime and has a 5% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s job-related knowledge, skills, and experience among other factors.

CHPW offers the following benefits for Full and Part-time employees and their dependents: 

•  Medical, Prescription, Dental, and Vision
•  Telehealth app
•  Flexible Spending Accounts, Health Savings Accounts
•  Basic Life AD&D, Short and Long-Term Disability
•  Voluntary Life, Critical Care, and Long-Term Care Insurance
•  401(k) Retirement and generous employer match
•  Employee Assistance Program and Mental Fitness app
•  Financial Coaching, Identity Theft Protection
•  Time off including PTO accrual starting at 17 days per year.
•  40 hours Community Service volunteer time
•  10 standard holidays, 2 floating holidays
•  Compassion time off, jury duty

Sensory/Physical/Mental Requirements:

Sensory*:

• Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical*:

• Extended periods of sitting, computer use, talking and possibly standing
• Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion
• Frequent torso/back static position; occasional stooping, bending, and twisting.
• Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.

Mental:

• Frequent decision-making. Ability to gather and assess data, determine appropriate actions, apply protocols and knowledge to unique situations, problem-solve and provide consultation.

Work Environment:

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.