L.A. Care Health Plan Even MORE Service Liaison I in Los Angeles, California
DUTIES The Even MORE Service Liaison will communicate to members in all LOB regarding: welcome calls, outbound calls, member -Health Risk Assessment, related programs by LOB . Conduct and document outreach activities (call, web, email) consistently and accurately. The Liaison will proactively identify, document, investigate, and resolve member issues in a timely and appropriate manner. The Liaison will also identify potential areas of membership dissatisfaction and recognize improvement areas. The Liaison is responsible for facilitating member enrollment and outreach efforts, with a focus on:
Health Risk Assessment- ensure to meet all regulatory requirements for CMS and for SPD population.
Contacting members to obtain their selection of PCP/clinic, medical group, (and Plan Partner, where applicable) assignment if information was not provided on choice forms, enrollment applications, data transmissions from applicable sources, etc. as well as the preferred threshold language and/or alternative format for receiving their welcome kits, network-related member notification letters, etc.
Collaborating with internal and external stakeholders and members to facilitate continuity of care and the related enrollments and assignments (based on enrollment information for Covered California, permission-to-enroll forms, daily updates from PASC, COBRA/ICP elections, etc.)
Processing and screening applications and renewals for Healthy Kids members, notifying applicants of the disposition of their application/renewal, and conducting the appropriate follow-up (including review of vendor outreach efforts)
Working with various internal, Plan Partner, medical group, etc. staff to address questions regarding member eligibility and demographic information
Collaborating with DPSS, Health Care Options, the Ombudsman, Covered California, PASC, third party liability constituency, etc. staff to address and resolve questions, issues, etc. regarding member demographic information (e.g., CIN, name, address, and other related information) so that it can be appropriately updated and reflected in the system. Liaison also attends and participates in various internal and external meetings in this regard..
QUALIFICATIONS & REQUIREMENTS
EDUCATION Required High School Diploma, plus training/certification in a technical or a business school.
Preferred: Associate's Degree
FOREIGN LANGUAGE Preferred Bilingual in one of LA Care Health Plan’s threshold languages: English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese, Korean
EXPERIENCE Required With High School Diploma/GED plus technical training/certificate in a technical or business school: a minimum of 2 years of customer service experience in a corporate setting
With Associate's Degree: minimum of a year (1 year) of customer service experience in a corporate setting
Strong verbal and written and communication skills Strong organizational skills Demonstrated experience handling complex customer calls
Preferred: Managed care or healthcare experience
Job Title: Even MORE Service Liaison I
Job Category: Administrative & Business Professionals
Department: Even MORE Outreach and Services
Location: Garland Building, Downtown Los Angeles
Position Type: Full-time
Position Control Number: 2037
Pay Grade: F