Bilingual Member Services Representative, Pair Team

• 3+ years of general work experience (healthcare call environments preferred)
• You are physically located in California
• Field Ops requires you to maintain reliable transportation for engagement at clinic, community based organization, and health system partner locations
• Virtual Ops requires a quiet, HIPAA compliant and internet connected space
• Bilingual – English/Spanish
• Telehealth experience in high volume call settings (inbound and outbound)
• Strong understanding of cultural fluency
• High degree of empathy
• Ability to work collaboratively in a multidisciplinary team
• An eye for optimization
• Organizational skills
• Ability to remain patient when faced with adversity
• Strong technical skills and comfort with technology innovation, past experience with CRM databases, basic Excel, Word, email, and video conferencing
• A valid driver’s license and auto liability insurance

Desirable

• We seek a full-time Bilingual Member Services Representative to play a critical role in our whole-person, interdisciplinary care model, responsible for directly outreaching and engaging with individuals living with Serious Mental Illness/ Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs
• We believe in the power of trust and relationships to successfully engage those who may have never received the kind of whole-health care that Pair Team can provide
• The Bilingual Member Service Representative will hold the title of a Lead Case Manager
• Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health goals
• Use relationship-based strategies to support members with social support navigation, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system
• Conducts periodic telephonic and SMS outreach to ensure timely follow-up to members
• Work with member to identify health/wellness goals and incorporate goals into Health Action Plan/Shared Care Plan
• Supports nurse care manager, behavioral health care manager, nurse practitioner and Community Engagement Specialist with delegated tasks
• Collaborates on care issues with Enhanced Care Management team by participating in systematic case reviews and consulting with nurse care manager, behavioral health care manager, and nurse practitioner before taking clinical actions
• Consistently meet monthly encounter metrics to ensure compliance with health plan regulations
• Identify and break down barriers ensuring individuals’ continuation with the program
• Assists individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups
• Coordinate physical care management appointments through collaboration with external and internal providers
• Utilize external and internal online platforms to collaborate with team members and carry out daily tasks