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Role Description

The Scheduling Specialist provides outreach and support to ensure all our eligible members have access to the care they deserve around our available Clinical/Patient Programs. Assists in navigating our members through the different programs they may be eligible and assists in scheduling them for what best suits their needs. Navigates with our members every step of the way to ensure they are never alone in their healthcare journey. Utilizes excellent customer service measures and understands the meaningful contribution the team makes to our members’ healthcare outcomes.

• Serves as a “subject matter expert” in the clinical programs that our members may be eligible for, including procedures, scheduling for Health Assessments, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries.
• Conducts member outreach phone calls and/or receives inbound phone calls within the department’s goal timeframe; manages to the member’s communication preferences as possible, which may include time of day, channel, and language; utilizes interpreter service as needed.
• Collaborates with our partners – including but not limited to other departments, Member Services, and Clinical Departments – to facilitate the member experience.
• Identifies members targeted for care gaps and other campaigns, and connects members to programs or services when appropriate; analyzes available programs, determines program eligibility, and connects member to appropriate provider or vendor.
• Responsible for real-time documentation and timely wrap-up to support outcomes reporting in all systems/applications as required; must enter member demographics and information with accuracy and attention to detail.
• Responsible for meeting or exceeding individual and team goals, and for submitting activity reports in the format and frequency required.
• Excels in customer service and contributes to a culture of going “above and beyond” to ensure the highest level of member satisfaction.
• Other duties as assigned.

Qualifications

• Required: Minimum 1 year of call center experience helping members navigate access to care through Medicare Advantage or HMO, including referrals and authorizations.
• Preferred: Experience in Clinical setting in managing provider schedules. Experience helping members navigate their Medicare Advantage benefits including medical, prescription drug, and supplemental benefits. Call Center experience in welcome/onboarding, appointment scheduling, retention, sales, or other health care/health plan related programs; and/or inbound call center experience that indicates a higher level of problem-solving such as escalation or resolution.
• Required: High School Diploma or GED.
• Preferred: College courses.

Requirements

• Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors.
• Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
• Mathematical Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
• Reasoning Skills: Ability to apply common sense understanding to carry out detailed, but un-involved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
• Computer Skills: Strong computer skills. Typing 40+ words per minute.
• Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
• Preferred: Bilingual English/Spanish, or Vietnamese, Chinese (Mandarin), Korean.
• Required: Must be available to work full-time and over-time through the Annual Enrollment Period (Oct-Dec) and Open Enrollment Period (Jan-Mar).

Benefits

• Pay Range: $41,600.00 - $57,600.00
• Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.