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Job Description
- Req#: 1317874
- Receives and processes telephone calls from Health Plan members requiring medical advice or general information by: Assesses the patients problem utilizing established protocols and interaction with provider on-site or on-call; makes appropriate recommendations to include advice, appointments per protocol, or direction from physician; appropriately documents calls received with adherence to inter-regional documentation; acts as an extension of the health care team to meet member needs.
- Assists members in empathetic, efficient manner to determine best course of action to resolve issue.
- Meets regional standards set by call center management to achieve optimal member satisfaction such as phone access and service standards. Be receptive to constructive feedback by supervisors and/or QI to better serve members.
- Contributes to the development of protocols, procedures, patient education, and training, as assigned. Participates in peer review, quality assurance, and other committees functions.
- Demonstrates ability to make quick decisions, based on sound base of critical thinking skills/guidelines by protocols.
- Demonstrate ability to interact with a variety of levels of staff to provide good customer service to internal customers.
- Performs other related duties as directed.
This position represents {2} openingsJob Summary:Responsible for medical triage of members using established protocols, note taking via online ANS (Advice Note System) and providing specified diagnostic results to members. Responsible to collaborate with on-site physicians, on-call physicians, HCT, pharmacists, and/or Nurse Practitioner as necessary to facilitate member care.
Essential Responsibilities:About the company
Providing high-quality, affordable health care services and improving the health of our members and the communities we serve.
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