Member Outreach Specialist

Job Summary:

Represents and acts as a liaison for the Organization by integrating all (new, returning and existing) members to Kaiser Permanente (KP) facilities and services. Facilitate all members with their integration activities to ensure high member satisfaction and member retention for the Organization.

Essential Responsibilities:

• Demonstrate commitment to superior customer service. Assist members with questions/concerns regarding the facility where they will receive their care and services. Assist members in their selection of personal care physicians (PCP) by phone, in person or e-mail. Provide specific facility information and/or brochures when needed.

• Schedule new and acute appointments for patients meeting medical criteria utilizing approved protocols within the departments, including quality screening appointments, pharmacy appointments, etc. Responsible for additional new member on-boarding, which may include (but not limited to) medical history intake (via phone, secure message, MDO) and activating Care Everywhere or other system in HC. Assist and empanel new members to PCP utilizing the process under the New Member Experience as required by Regional TPMG and Health Plan to meet deadlines and regulatory requirements.

• Ensure all members are informed about how to access kp.org and assist in establishing an account with KP. Provide information on how to access and download the Preventive Application or other KP applications to a mobile device. Provide information on accessing and downloading all appropriate KP applications.

• Meet the dis-empanelment and transition requirements for quality of care services by TPMG and the Health Plan for all providers, including PCP, specialists and non-physician providers.

• Work with departments on member transitions and provider transitions, including Pediatrics to Medicine, provider transitions such as retirements, etc. Perform, manage and maintain the Providers Transitions Notification and Tracking System (PTNT) to ensure transitions are completed to meet Regional TPMG and Health Plan processes and regulatory requirements.

• Ensure Regulatory Compliance for Federal and State Programs for new members are met.

• Responsible for maintaining the KP website for physician selection, individual physician websites, and other KP websites when assigned. Take and upload physician and provider photos as required.

• Meet strict mandatory requirements for quality of care and services by Regional TPMG and Health Plan. Maintain and update the Member Outreach System (MOS) or other systems as appropriate for completion of personal care physician linkage and member outreach attempts and outcomes.

• Maintain accurate medical background information of our physicians/providers for our members; including up-to-date information for Welcome to my Practice and other letters as needed. Generate letters as needed. Work with all stakeholders in medical facilities to facilitate continuity of care and provision of services.

• Assist in the New Member Orientation and tours including presentations and materials. Assist non-English speaking members in their needs for facility integration and physician linkage. Compile statistical data and generate weekly or monthly reports to manager when required. Perform miscellaneous duties assigned by the manager.

Grade: 126

Basic Qualifications:

Experience

• Minimum two (2) years of experience in customer service or in a health care environment required.

Education

• High School Diploma or General Education Development (GED) required.

License, Certification, Registration

• Driver's License (California)

Additional Requirements:

• Knowledge of PC applications including Basic proficiency in MS Word and Excel, testing required.

• Must possess high level of skills in customer service

• Excellent verbal, telephonic and written communication skills required.

• Strong interpersonal and organizational skills.

• Able to work independently and as a team member

• Ability to work collaboratively with physicians, providers, and all levels of staff

• Must be willing to work in a Labor Management Partnership environment.

• May need to travel within the Service Area to support operations.

Preferred Qualifications:

• Medical Assistant experience

• Bachelors degree preferred.

• Medical Assistant training preferred

COMPANY: KAISER

TITLE: Member Outreach Specialist

LOCATION: Martinez, California

REQNUMBER: 1442739

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.