Why This Role is Important to Us

The Specialist works to ensure that member needs are addressed through liaising with internal CCA providers and external healthcare providers.

The Specialist also educates the member on

health plan offerings and addresses members’ questions or concerns.

What You'll Be Doing

• Serves as the primary member contact and advocate until their care team is established, both through direct member outreach and inbound call support
• Leverages internal and external resources (such as claims, referrals, and pharmacy data) to identify accurate, successful contact information for unreachable or hard-to-reach members
• Orients new members to the value of CCA as their health plan, providing education, answering members’ questions, anticipating, and meeting member needs and concerns
• Documents members’ current healthcare services and new service requests
• Ensures members continue to receive current healthcare services as they transition to CCA through healthcare provider outreach and education
• Schedules new members’ initial nurse intake visits
• Utilizes communication skills such as motivational interviewing to gain agreement from members to participate in the onboarding process, persistently forging trusting relationships and engaging individuals not readily interested in connecting with CCA
• Utilizes established workflows and collaborates with internal and external stakeholders and healthcare providers
• Provide clinical care to members via telehealth technologies (video, chat, etc.) for a clinically appropriate clinical care and care management services.

Last updated : 2024-03-02