Population Health Assistant – Blue Cross and Blue Shield of Kansas City – Kansas City, MO

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Job Description Summary :

Provides day-to-day operational support to Care Management programs within the Population Health Department. Leverages an empathetic advocacy approach in engaging with members to ensure seamless onboarding to relevant programs. Proactively problem-solves member-related issues including but not limited to referral management, member concerns, complaints or inquiries. Serves as liaison between Blue KC and external stakeholders including members and vendor partners. Coordinates and collaborates with internal Subject Matter Experts to ensure program success, resolve member issues and deliver world-class experience.

Job Description

• Operates as the liaison for member benefits and healthcare needs and utilizes all forms of communication effectively to maximize a collaborative relationship (including incoming/outgoing phone calls, email, web-based and other relevant communication channels). Has the ability operate successfully in an ambiguous environment that requires a degree of adaptability, agility and reliability and escalates member concerns to applicable stakeholders when required.
• Acts as critical “care team” member in a matrix environment and works closely with the Care Management nurses, the Quality and Community Health teams, and support system to engage the member/patient. Educates and works with members at different educational and health literacy levels in a culturally sensitive manner. Assesses the member’s need for education and tailors teaching to the member’s knowledge level and learning style.
• Maintains confidentiality of all regulated information in compliance with state and federal laws; Reads, understands and follows medical policy and all corporate, divisional and departmental policies and procedures. Including but not limited to: Protected Health Information (PHI), Personal Identifiable Identification (PII).
• Ensures compliance with applicable URAC and National Committee for Quality Assurance (NCQA) accreditation guidelines and state and federal regulations.
• Meets targets for program and individual quality standards, such as monthly and annual productivity and performance goals as mutually agreed to by management team to maximize program value. Schedules time effectively. Works with minimal supervision. Handles multiple projects simultaneously. Prioritizes work appropriately.
• Comfortability with multiple systems and tools with Microsoft Office Suites proficiency required.
• Partners with the rest of the team to develop and implement new programs, tools, systems, and capabilities as business needs arise.
• Other duties as assigned.

Minimum Qualifications

• Associate’s degree in healthcare or health coaching related field
• 1-3 years’ work experience
• Ability to navigate a variety of tools and applications to support members through various communication channels
• Intermediate proficiency with Microsoft applications
• Comfortable with health related applications
• Experience and understanding of health insurance

Preferred Qualifications

• Healthcare, customer service, and coaching experience