Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
The Customer Outreach Advocate supports Community Health Choice campaigns that align with the operational needs of the organization. The Customer Outreach Advocate is responsible for handling non-clinical inbound and outbound calls to our Customers (Members and Providers). The Customer Outreach Advocate is also responsible for assisting Members with renewing their health benefits by offering application assistance and other resources that help with the re-enrollment process. This role supports our internal partners by conducting outreach through providing reminders, education, scheduling assistance, and more, along with working to improve member retention.
JOB SPECIFICATIONS
Essential Functions
25% Performs outreach calls to support Member and Provider campaigns for a wide variety of inquiries and assistance involving benefits, claims, medical appointments/transportation and more.
25% Educates, assists and coordinates health services for members through effective communications on inbound and outbound calls
25% Completes ad-hoc requests to ensure the safety of environment and well-being of our membership in support of Outreach affairs
10% Demonstrates effective telephone skills
15% Demonstrates effective customer service skills
Marginal Functions
Utilizes time effectively
Reports to Position Title: Customer Engagement Supervisor
Employees Supervised Titles: N/A
MINIMUM QUALIFICATIONS:
Education/Specialized Training/Licensure: High School diploma or GED or equivalent
Work Experience (Years and Area): 3 years relevant work experience of which: Two years of experience in health care/plan, call center, customer service, and/or sales.
Must have CHW certification or obtained within the first 6 months of employment.
Management Experience (Years and Area): N/A
Software Proficiencies: Microsoft Office (Word, Excel, Outlook)