Case Management Outreach Specialist

Job Summary

A company is looking for a Case Management Quality Outreach Specialist III.

Key Responsibilities

• Conduct telephonic outreach to members and providers for triage and engagement in quality outreach campaigns
• Support quality improvement initiatives and enhance member outcomes by providing education and assistance with access to care
• Secure medical records from external providers to support quality standards and close care gaps

Required Qualifications

• High School diploma or equivalent combination of education and work experience
• 3+ years of experience in a member-facing telephonic engagement and/or service support role
• Experience in a customer service, call center, managed care, or healthcare-related environment preferred
• Familiarity with healthcare quality improvement standards and principles, including HEDIS and Gaps in Care