Outreach Coordinator II - Bilingual - Spanish / Job Req 772061066 (Project Management)

PRINCIPAL RESPONSIBILITIES:
Under the direction of the Senior Manager of Communications & Outreach, the Outreach Coordinator is responsible for supporting the implementation and coordination of the Alliances outreach objectives. This position is responsible for building a positive Alliance presence among members, providers and community stakeholders and serving as a primary contact in our community. This position works to make the Alliance the plan of choice in our community, to connect members to routine care and can also serve as a liaison for member issues. This position also serves as a liaison between the plan, the provider network, and other community agencies. The OC positions are a flexiblystaffed classification, and work is expected to be performed minimally at the OC II level. However, the initial selection will be made at the entry-level OC I. Our more advanced level position of the series is the OC III, which will be required to perform a variety of complex activities. Outreach Coordinators service our stakeholders through our outreach events and activities. This postion may serve will also assist other departments with responses to stakeholder issues by initiating communication between departments to ensure action, cooperation, compliance of managed care operations and the highest levels of customers service.
The Outreach Coordinator II
The OC II position represents the recognition of an advanced level OC I staff who have demonstrated proficiency in the job requirements (production, compliance, attendance/punctuality, outreach activities, website inquires, and in-person and virtual member inservices for member benefits, and web-based member portal resources.) for an OC I.
OC II staff who demonstrate proficiency in meeting, maintaining, and exceeding departmental performance measures for and objectives for outreach including outreach activities, and member inservices for member benefits and the web-based member portal may be eligible to be promoted to III role. Outreach Coordinator II may be eligible for promotion to Outreach Coordinator III positions once they have worked as an OC II for a minimum of 12 months and demonstrate proficiency with program and system knowledge in addition to meeting performance requirements.
Principal responsibilities include:
Provide excellent customer service. Participate in community events as representatives of the Alliance to strengthen the presence of the Alliance within our local community and stakeholder groups, and as needed, outside of regular business hours. Act as the primary point of contact and liaison in the community for Alliance members, providers, and others regarding general inquiries, concerns, or requests for information. Respond to and resolve member and community inquiries and issues by identifying the topic and type of assistance the stakeholder needs, such as benefits, eligibility, claims, behavioral health, and care coordination Follow established guidelines and schedules, maintain team and individual workflow processes to meet individual and department performance standards. Use listening skills and judgment to categorize appropriately and accurately document all contacts and follow-up actions regarding member and provider communications and activities following established guidelines; Work collaboratively with the Communications & Outreach Senior Manager to staff community outreach events outside of regular business hours. Research issues using HealthSuite, ODS, and portals, and work with support resources to resolve member inquires and partner with other departments to resolve escalated issues. Educate members and providers on eligibility, and medical and pharmacy benefits and how to access services in a manner that achieves excellent service standards and maintains high customer satisfaction; Appropriately handle member and provider requests through alternative channels such as e-mail, voicemail, fax, in-person, etc. following established procedures; Triage member and provider requests or inquiries for other departments; Conduct member surveys as assigned following established guidelines. Interface with Enrollment, Member Services, IT, Network Management, and other internal departments to provide Service Excellence to our members. Assist members in navigating alamedaalliance.org, the Member Portal, and other health care partner online resources and websites to encourage/reassure them to use self- service tools that are available. Meet the performance goals established for the position in the areas of efficiency, quality, member satisfaction, timeliness, punctuality, and attendance. Ability to work in either Alameda or other locations within Alameda County. Maintain a professional level of service to members and stakeholders at all times. Maintain confidentiality of information at all times; Establish and maintain relationships with community stakeholders and partners. Conduct 1:1 presentation with community stakeholders. Conduct group presentations for community groups. Identify and schedule community meetings and event opportunities. Provide information at member in-services, fairs, and regularly scheduled community events. Identify new outreach opportunities among the member demographic. Follow prepared scripts and talking points to give program and benefit information. As directed, assist management staff in the completion of special projects; perform other job-related duties as assigned and required. Attend, and actively participate in, Member Advisory Committee meetings. Promote the Members Rights and Responsibilities. Attend and actively participate in departmental meetings, in-services, and training; Identify member/provider/community stakeholder issues and trends and report relevant information to management; Perform other related duties as required or assigned; Conduct telephonic member outreach regarding Medi-Cal benefits and services.
ESSENTIAL FUNCTIONS OF THE JOB
Conduct outreach efforts, presentations, and meetings which may require working outside regular business hours. Professionally represent the Alliance in the community at all times. Develop and maintain effective professional relationships with local community and stakeholder groups. Receive, manage, and document telephone calls, emails, and other sources of contacts from members, potential members, and providers and explain health plan benefits and plan rules. Describe the types of services the Alliance offers to the Member within the managed care system. Provide clarification about issues regarding patient and physician rights and how the plan operates. Resolve member/provider/community partner problems/conflicts by convening with other departmental staff as needed. Create and mail appropriate member materials and communications as needed. Participate in both departmental and non-departmental meetings. Perform ongoing data entry, which assists in the maintenance of the Communications and Outreach, and Member Services department database to ensure data integrity. Complete various administrative functions. Comply with the organizations Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
PHYSICAL REQUIREMENTS
Constant and close visual work at desk or computer. Constant sitting and working at desk. Frequent use of telephone headset. Constant verbal and written communication with staff and other business associates by telephone, correspondence, or in person. Ability to think and work effectively under pressure; ability to effectively serve customers; decision making; maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. Frequent lifting of folders and other objects weighing between 0 and 30 lbs. Frequent walking and standing. Occasional driving of automobiles.
Number of Employees Supervised: 0
The ability to speak, write, read and understand-bilingual: Spanish/English, Mandarin or Cantonese/English, Vietnamese/English, Tagalog/English, Arabic/English are required as designated. Possession of a valid California drivers license and auto liability insurance required. Team-oriented with a positive attitude. Excellent oral communication skills and the ability to target key messages to audiences, including the ability to express oneself clearly and concisely when providing service to Alliance plan members and providers over the telephone, in person or writing; Desire to work with low-income, at-risk and underserved populations. Self-directed with proven ability to work independently and as part of a team with some supervision, able to exercise judgment and make decisions appropriate for the scope of the position; follow up on assignments; handle multiple projects simultaneously and demonstrate flexible nature. Ability to handle multiple projects and balance competing priorities. Ability to plan and execute projects independently. Ability and desire to handle and document 10-15 outreach calls per day in HealthSuite and department tracking logs, excellent multi-tasking skills; Positive attitude and ability to work in a team setting; Ability to work independently within specified time constraints; Ability to adapt and perform duties efficiently when unexpected changes arise; Adherence to specific work schedules required; Familiarity with standard concepts, practices and procedures within the healthcare field. Knowledge of customer service principles and practices. Well organized and detail-oriented. Must be flexible with schedule, including weekends. Proficient computer application competency, including Microsoft Suite (Word, Excel, PowerPoint, Outlook). Experience with MS Publisher preferred.
MINIMUM 2 YEARS OF ADDITIONAL RELATED EXPERIENCE FOR OC II:
Experience determining eligibility for financial assistance; insurance benefits; unemployment, and other social services programs; Demonstrated knowledge expert of Alliance Member Services and Marketing policies and procedures; Demonstrated track record of schedule adherence (punctuality and attendance), including consistent use of the companys time tracking solution to track working hours. Consistent record of meeting, maintaining or exceeding monthly outreach production metrics. Consistent track record of documenting Service Requests accurately and clearly, and monitoring open Service Requests to ensure responses and closure. Demonstrated proficiency in the current phone system software, Interpreter vendor scheduling software, and the Alliance Member Portal. Demonstrated ability to handle the department's special projects effectively. Demonstrated ability to assist members face-to-face in the field and at community events. Also highly skilled at handling issues related to transportation set-up, and care coordination with providers and pharmacy needs.
MINIMUM QUALIFICATIONS:
EDUCATION OR TRAINING EQUIVALENT TO:
Bachelor's Degree in a health-related field or equivalent four years of office support/customer service work experience including a minimum of one (1) year of Medi-Cal Managed Health Care call center environment experience determining eligibility for financial assistance, insurance benefits, unemployment, or other social services programs.
MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:
Minimum of three years' experience in managed health care call center, Medi-Cal managed care, or eligibility preferred.
SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):
Excellent interpersonal skills with the ability to interact with diverse individuals and flexibility to customize the approach to meet all types of member communication styles and personalities; Strong verbal and written communication skills; Demonstrated ability to quickly build rapport and respond to members compassionately by identifying and exceeding member expectations (responding in a respectful, timely manner, consistently meeting commitments); Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member; Must be self-motivated and able to work with minimal supervision. Must be team-oriented and focused on achieving organizational goals; Proficient problem-solving approach to quickly assess the current state and formulate recommendations; Skilled in translating healthcare-related jargon and complex processes into simple, step-by-step instructions which members can understand and act upon; Proficient conflict management skills to include the ability to resolve issues during stressful situations and demonstrating personal resilience; Ability to work regularly scheduled shifts within the Alliance hours of operation including the training period, with scheduled lunches and breaks, flexibility to adjust daily schedules; and to work overtime or weekends as needed; Medical terminology and managed care knowledge preferred; Ability to work within a broad systems perspective. Experience in the use of various computer systems/software (Microsoft Windows, and Microsoft Suite, especially Outlook, Word, and Excel).
Employees who interact with members of the public may be required to be tested for Tuberculosis and fully vaccinated against COVID-19 and influenza. Successful candidates for those positions/ classifications may be required to submit proof of vaccination against influenza and/or COVID-19, a negative Tuberculosis test, or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not present proof of vaccination until instructed to do so by the Human Resources department.
SALARY RANGE: $72,384.00 - $108,596.80 Annually
The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M/F/Vets/Disabled.