Relationship Establishment Specialist - Bilingual | San Diego

The following job description will cover the requirements and expectations for the Relationship Establishment Specialist - San Diego position.

Job Title: Relationship Establishment Specialist

Reports to: Outreach Manager

Department: Call Center

DOL Status: Non-Exempt

Job Summary: Member facing role in San Diego.

Position Responsibilities:

• Conduct in-person and telephonic outreach as needed to comply with ECM guidelines.
• This position will require significant in-person outreach, with an estimated time commitment of 50-80% of working hours spent on fieldwork and face-to-face interactions.
• Meet members where they are during in-person outreach, locations include but are not limited to the members home, apartment, shelter, hospital, facility, etc.
• Follows established policies to outreach, enroll and exclude members.
• Verify eligibility for enrollment in the Enhanced Care Management program (ECM).
• Complete a referral to the ECM program when necessary.
• Conducts appropriate member assessments telephonically and/or in-person.
• Complete necessary documentation and upload to our EMR.
• Responsible for coordinating with individuals and/or entities to ensure a seamless experience for the members and non-duplication of services.
• Partners with healthcare professionals, community and social support services, and other healthcare entities to locate members.
• Communicates and collaborates with Lead Care Managers (LCMs), regarding the members' progress and care needs.
• Identifies, coordinates, and follows-up on member referrals to ensure continuity of care, and member needs are being met.
• Investigates and directs member inquiries or complaints to appropriate staff members and follows up to ensure satisfactory resolution.
• Follows established protocol around patients experiencing pain, safety concerns and/or mental health concerns and creates safety plans, if necessary.
• Recognizes signs of child and elder abuse and reports appropriately to Child/Adult Protective Services.
• Understands and abides by all departmental and companywide policies and procedures.
• Complies with all safety and injury prevention policies and regulations.
• Performs other duties as assigned or required.

Position Requirements:

• Member facing role in San Diego County and surrounding counties.
• Language: Fluent in English and Spanish (written and verbal).
• License/certification: Current and valid Driver’s License and proof of auto insurance.
• Skills required: Competent with computers, email, virtual platforms, MS Excel, MS Word, MS PowerPoint, MS Outlook, and other Microsoft Office based programs.
• Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear, effective manner.
• Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures.
• Ability to stand/walk for long periods of time
• Ability to lift/carry 10lbs

Preferences (not a requirement for the role):

• High School Diploma
• +1 year of experience as an outbound call center representative.
• An equivalent combination of education and experience that provides the skills, knowledge, and ability to perform the essential job duties, and which meets any required state or federal certification requirements.
• 1 year of experience in healthcare or social service
• Proficiency in EMR system

Benefits:

• 100% Employer-covered health benefits (for qualifying medical plans) options
• Competitive Medical, Dental, and Vision plans with PPO and HMO options
• Employee Assistance Program
• Paid Holidays, PTO, and Sick Time
• Up to 3 weeks of PTO accrual per year
• 11 Company-Paid Holidays
• Up to 6 Sick days accrual per year