ACCESS Member Services Specialist

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🕒 6 dias atrás

🌲 North Carolina – Remoto

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💵 $54.007 - $65.000 / ano

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

👻 Score fantasma 1%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Vaya Health

Vaya Health

501 - 1000 funcionários

Fundada em 1972

🛡️ Seguros

💼 Consultoria

📦 Logística

Insurance • Consulting • Logistics

A Vaya Health é uma organização sediada na Carolina do Norte que gerencia serviços para indivíduos com problemas de saúde comportamental, incluindo transtornos mentais e de uso de substâncias, deficiências intelectuais e de desenvolvimento (I/DD) e lesões cerebrais traumáticas (TBI). A organização fornece serviços de Medicaid personalizados para essas populações, com foco em uma abordagem centrada na pessoa que conecta os membros ao cuidado e suporte necessário para seus objetivos únicos de saúde e bem-estar. A Vaya Health enfatiza a colaboração em várias áreas de cuidado para garantir apoio abrangente aos seus membros, promovendo comunidades mais saudáveis em toda a região.

Descrição

• Conduct telephonic screenings and collect demographic information • Review and confirm member and recipient eligibility • Offer provider choices based on consumer requests and service needs • Schedule appointments within established access time standards • Link members with contracted providers for clinical assessments • Identify risk indicators and make immediate referrals to Member and Recipient Services Clinicians • Handle customer service calls regarding enrollment, services, referrals, provider changes, Social Determinants of Health needs, and general information • Provide information about Vaya Partners, its provider network, community resources, and North Carolina Medicaid services • Complete warm transfers and link callers to appropriate parties, providers, vendors, community organizations, and legal guardians • Document call notes, forms, reports, and other required information in electronic systems • Report service-system gaps and needs to managers or Provider Network Development staff • Offer Customer Satisfaction Surveys and adhere to the NCMT Call Grading Rubric • Assist with specialized ACCESS Call Center projects and perform other assigned duties

🎯 Requisitos

• Bachelor’s degree in a Human Services field and at least two years of experience working with adults or children with serious psychiatric, chemical dependence, or developmental disability in a community mental health center or similar setting, OR a Bachelor’s degree from an accredited college or university and at least four years of such experience • Must be qualified as a Qualified Professional according to 10A NCAC 27G .0104 • Experience providing mental health, substance abuse services, or intellectual/developmental disabilities • Knowledge of social work principles, techniques, and practices • Knowledge of behavioral health principles and complex treatment and service provision • Knowledge of person-centered and recovery philosophies • Familiarity with mental health, developmental disability, and substance abuse disorders • Knowledge of North Carolina’s Medicaid system • Knowledge of laws, regulations, and policies governing human services and utilization management • Ability to use complex telephone and computer systems and multiple technology systems concurrently during live calls • Ability to document information electronically and complete required documentation at the time of the call • Ability to communicate clearly orally and in writing • Ability to interact professionally with upset or disagreeing individuals • Must reside in North Carolina or within 40 miles of the North Carolina border

🏖️ Benefícios

• Overtime compensation eligibility • Extensive training on customer service skills, insurance plans, applicable confidentiality laws, and related systems • Equal opportunity employer

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