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Community Outreach Rep in Washington, DC at Integrated Resources, Inc

Date Posted: 11/8/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    11/8/2018

Job Description

Under the supervision of the Community Outreach Services Team Supervisor, the Community Outreach Services Representative interfaces with members in person, on the phone and through correspondence as appropriate to communicate key care management, benefit administration and health promotion messages. The COS Representative will also collaborate with the medical management team to identify solutions to address environmental factors and social determinants that may be impacting members health. The COS Representative will support and work on health promotion programs including but not limited to health fairs, community events and targeted outreach and/or care management programs Meets members at their residence, provider offices and other community locations to inform them about gaps in care, pending eligibility expiration, upcoming programs and other key messages related to their benefits and/or Medicaid status. Engages members at their home or in a care setting, such as a hospital room or emergency room, to help him or her arrange transportation home, fill prescriptions, schedule follow-up appointments and obtain answers to questions related to next steps after being discharged from the hospital or emergency room. Follows up with members at their residence to communicate information from their care manager, assists them in understanding their care plan and also collects and documents relevant information about their home environment and other identifiable social determinants that may potentially be impacting their health. Observes members general physical and mental state and documents findings as appropriate. Together with case managers and clinical staff, supports members in case management through the early part of their care so they participate fully, become educated and advocate for themselves. Provides personalized assistance and encouragement to members to help them seek appropriate medical care and counseling. Contacts members by phone (voice and text) as appropriate to communicate key messages and to help them schedule appointments with their PCP and other providers. Sends letters and other information to members as follow-up messaging for successful and attempted home visits and/or phone calls. Presents Client DC benefits to members and explains how to access them in both group and one-on-one settings. Educates and assists members on how to recertify for their Medicaid benefits and how to enroll with a managed care program via the enrollment broker process. Educates members on the benefits of establishing both a primary care medical and dental home. Collaborates with provider staff to develop strategies that will help establish the provider s practice as primary medical home for their assigned members. Leverages company resources to help members and providers resolve benefit administration issues, confirm member eligibility and appointments, and schedule members for gap in care, HEDIS and EPSDT appointments. Maintains and follows proper protocol for documenting member encounters, activity logs, and other back office responsibilities in an accurate and timely manner. Participates in special projects as assigned. Adheres to AMFC policies and procedures. Supports and carries out the AMFC Mission & Values. Other duties as assigned.

Experience: Two to five years of health care, social work, human service experience or equivalent. Broad knowledge of the healthcare industry and marketplace (preferred) Broad knowledge about the assigned community, specific health issues and health and social service systems (preferred). Licenses, Registrations or Certifications: Home Health Aide and/or Direct Service Professional Certificate or equivalent (preferred) Current driver s license (preferred)