Member Outreach Representative

Full Time
Worcester, MA 01608
Posted
Job description
Overview:
About Fallon Health:
Fallon Health is a mission-driven not-for-profit health care services organization based in Worcester, Massachusetts. For 45 years we have been improving health and inspiring hope in the communities we serve. Committed to caring for those who need us most, we pride ourselves on providing equitable access to coordinated, integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program of All-Inclusive Care for the Elderly (PACE). Dedicated to delivering high quality health care, we are continually rated among the nation’s top health plans for member experience and service and clinical quality.

Brief Summary of Purpose:
Under the direction of the Market Research Manager, supports Fallon by making Welcome/Outreach calls to members and/or survey calls to members or providers. Handles confidential patient/member information. Uses strong verbal communication skills and demonstrates excellent telephone communication skills. Understands the importance of leaving a positive impression on any member with whom they come into contact. When necessary, assists member through the creation of formal research cases.
Responsibilities:
Job Responsibilities:
  • Exhibits courtesy, compassion, empathy, and respect in all outbound communications with members and providers. Utilizes proper judgment in handling difficult or unusual calls.
  • Responsible for learning and keeping current with Fallon products, policies and procedures.
  • Responsible for documenting the results of all outbound calls using an electronic or written form.
  • Makes Welcome/Outreach telephone calls to Fallon members providing product knowledge, customer assistance, and problem solving.
  • Administers member telephone surveys. Working from a script, asks both open-ended and closed ended questions of members in order to capture information such as why the member joined Fallon, how satisfied the member is with Fallon and why the member left Fallon.
  • Maintains the highest degree of member/patient confidentiality.
  • Works both as a team member and as an individual depending on assigned project.
  • Works on special projects and other tasks such as focus group recruitment and data entry as assigned by the Market Research Managers or executive staff.
  • Assists Fallon members by creating formal research cases. When necessary, is responsible for properly documenting member issues and entering information into a specialized company database.
Qualifications:
Education:
High School Diploma

License/Certifications:
N/A

Experience:
  • Minimum of one year Customer Service experience in a call center environment
  • Computer skills

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Fallon Health Vaccination Requirements:
To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022 all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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