• Job Description

  Req#: 2913

  Overview

  This position provides support and guidance to Partnership HealthPlan of California (PHC) members for wellness services and incentive programs in a call-center environment. The Wellness Guide works closely with members and their families to encourage members to engage in healthy activities (including preventative care visits and chronic care management), remind members of available benefits, and connect members to available internal and external resources.

  Responsibilities

  • Performs wellness campaign outreach activities for assigned membership/campaigns. Provides members with information about benefits supporting member wellness and helps members schedule appointments for wellness services.
  • Engages members to discuss wellness programs and health screening opportunities.
  • Maintains active caseload and call volume appropriate to the acuity of the outreach campaign.
  • Appropriately screens members and refers to community resources, providers, and additional PHC resources and programs (Healthy Living programs, Case Management support) in accordance with department guidelines.
  • Conducts targeted assessments to encourage members to remain healthy and to support campaign goals.
  • Initiates and processes referrals to appropriate Care Coordination programs in accordance with PHC policies.
  • Completes timely and accurate documentation in appropriate systems in accordance with department policies.
  • Responds to member queries on the ACD telephone line, determines call urgency, and routes calls appropriately.
  • Provides excellent customer service and communicates with others in accordance with PHC standards and expectations.
  • Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and PHC employees.
  • Responds to inquiries in a timely manner.
  • Connects members to wellness services and community resources, as appropriate.
  • Exhibits high professional standards as outlined in PHC's Code of Conduct.

  SECONDARY DUTIES AND RESPONSIBILITIES

  • Provides support and assistance to Wellness Guide staff, as needed.
  • Collaborates with internal PHC departments to resolve issues.
  • Attends required meetings and trainings in-person, when assigned.
  • Provides periodic coverage during vacations or sick time for Wellness Guide staff as needed within assigned team.
  • Performs other duties as assigned by the direct supervisor, including the assumption of new duties.

  Qualifications

  Education and Experience

  High school diploma or equivalent combination of experience and education required; associate’s or bachelor’s degree preferred. Two

  (2) years of experience working in a health care setting recommended, to include experience in health coaching, behavioral change, or any work experience, training or specialized education that would likely provide the ability to perform the essential functions of the position. Preference may be given to individuals certified and/or licensed in a health-related field.

  Special Skills, Licenses, and Certifications

  Ability to use good judgment, take personal initiative, and use discretion in performing job responsibilities. Attention to detail and accuracy. Basic knowledge of medical terminology and coding. Ability to listen actively and practice motivational interviewing. Ability to use computer software for word processing, spreadsheets, and email, operating multiple computer programs simultaneously. Ability to function effectively with frequent interruptions and direction from multiple team members. Ability to work in an environment with diverse individuals and groups. Ability to establish collaborative relationships. Ability to work autonomously within a team setting. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Bilingual skills in a PHC threshold language preferred. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.

  Performance- Based Competencies

  Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and PHC employees. Models appropriate behavior for department. Ability to work effectively with Medi-Cal and other special needs populations. Ability to work with ethnically and culturally diverse populations. Ability to maintain positive, cooperative relationships with

  the community, professional groups, public officials, and agencies, and represent the department with professionalism. Ability to manage multiple tasks.

  Work Environment and Physical Demands

  Standard cubicle workstation with a shared common area. Use of telephone, fax, computer, and photocopying machine is required. Requires sitting in front of computer equipment and talking on telephone for major portion of the workday. Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. When necessary, must be able to lift, move, or carry objects of varying size, weighing up to 35 lbs. Face-to-face contact with members may be expected.

  All HealthPlan employees are expected to:

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

  HIRING RANGE:

  $ 24.12 - $ 29.55

  IMPORTANT DISCLAIMER NOTICE

  The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

• About the company

  Partnership HealthPlan of California, is an independent, public/private organization serving over 550,000 Medi-Cal beneficiaries in 14 northern California counties: Del Norte County, Humboldt County, Lake County, Lassen County, Marin County, Mendocino ...

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