What are the responsibilities and job description for the Lead Patient Engagement Specialist (Remote Eligible) position at Clarest Health?

Description

CSS Health (a division of Clarest Health) is a software company that supports health insurance companies by providing software solutions and outsourced services. We license software to help manage medical programs, particularly the Medication Therapy Management (MTM) Program required by CMS for Medicare Part D. We also offer outsourced MTM services, utilizing our team of pharmacists, clinicians, and support staff to conduct Comprehensive Medication Reviews (CMRs) for our clients' members. These reviews are crucial for maintaining high star ratings in Medicare Part D programs.

The Lead Patient Engagement Specialist will oversee daily operations of the Patient Engagement Team, conduct quality audits, and assist with training. Responsibilities include reviewing policies, performing outreach to MTM-eligible members, managing data and providing administrative support. The role also involves operating software, while adhering to CSS policies and HIPAA guidelines.

Location : Remote or Hybrid (Buffalo, NY)

Salary : $20 / hr | $21 / hr for Bilingual (Spanish)

Reports To : Patient Engagement Supervisor

Schedule : Monday through Thursday 11am- 7pm, Friday 9am to 5pm EST

What We Offer :

Comprehensive Medical, Dental and Vision Insurance (as low as $13.33 / pay)
Paid Time Off
Free Virtual Care – Telemedicine
401k with company match
Referral Bonuses
Life Insurance
Make a difference in the lives of others!
We are growing and that means more opportunities

Key Responsibilities :

Lead Responsibilities (70-80% of role)

Conduct quality assurance audits on CSS PES Agents.

Assist in onboarding and training new employees, as well as providing continuing education and training for current employees.

Review and update policies and procedures related to the Patient Engagement Team.

Patient Engagement Specialist Responsibilities (20-30% of role)

Perform telephonic outreach to MTM-eligible members as per CSS client’s program specifications.

Accurately collect and record data into the MTM-eligible member’s MTM chart, following decision-based logic within the platform, in preparation for the clinical interview.

Follow all established CSS policies and procedures, including but not limited to HIPAA, privacy and security policies and procedures.

Receive inbound calls, conduct outbound calls and direct calls to appropriate parties.

Provide administrative support functions as needed.

Operate office equipment such as voice mail messaging systems, email, and various software applications to support CSS’s MTM operational processes.

Perform other duties or tasks as assigned or required.

The ability to adhere to Clarest’s Code of Conduct, follow Clarest Compliance policies and procedures, and report any suspected violations of any federal or state laws to either their direct supervisor, Human Resources or the Compliance Officer

Qualifications :

At least 1 year of experience in a call center environment required

At least 1 year of experience performing telephone outreach to customers (patients preferred)

HS diploma / GED required

Microsoft Suite (Excel & Word) experience required

Understanding and following HIPAA, Privacy, Safety and Compliance guidelines preferred.

Must have high-speed internet

Ensure a quiet, private workspace that is free from interruptions and distractions, allowing you to focus and perform tasks efficiently while working remotely

Skills Abilities :

Ability to work as a team member

Maintain professionalism, and have excellent communication skills

Extreme attention to detail

Positive professional work ethics are essential

Continuously improve knowledge and skills, demonstrating a strong willingness to learn and adapt

Proficient with computers and comfortable learning new programs

Excellent verbal and written communication skills, with the ability to convey information clearly and empathetically

Clarest is an Equal Opportunity Employer. Reasonable accommodations will be made to enable individuals with disabilities to apply for a job or to perform the essential functions of their job. Please advise us if you require a reasonable accommodation.

Salary : $20 - $21

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Lead Patient Engagement Specialist (Remote Eligible)

What are the responsibilities and job description for the Lead Patient Engagement Specialist (Remote Eligible) position at Clarest Health?

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