PacificSource Health Plans

Health Services Representative II

US-OR-Eugene
Job ID
2017-390
Type
Regular Full-Time
Hiring Pay Range
15.00-18.27
# of Openings
1
Status
Non-Exempt

Overview

Assist the Health Management team to implement, coordinate, and maintain all Health Management programs for PacificSource members.  This includes, but is not limited to, responding to vendor and member requests for information, coordinating and attending meetings, data maintenance and reporting, and written and telephonic communications.  The goal is to maximize the members’ quality of health/life and to effect positive change in on-going utilization of healthcare services over time.

Responsibilities

Essential Responsibilities:

Assistance in implementation and maintenance of condition support programs including but not limited to:

  1. Effectively handle a large amount of contact (outbound telephonic and written) with members, as directed and independently, including mailings, emails, and other tasks as assigned.
  2. Exhibit customer service excellence in all external and internal contacts, including assessing customer needs and meeting quality standards.
  3. Develop knowledge about all Health Management program components and proactively remain informed on any changes and provide feedback as they are implemented.
  4. Assist clinical staff with obtaining information for programs in Health Management.
  5. Accurately document in case management software
  6. Attend meetings and document pertinent notes.
  7. Respond to internal requests for report data.
  8. Observing, receiving, and obtaining information/data from all relevant sources
  9. Entering, transcribing, recording, storing, or maintaining information in written or electronic.
  10. Manage mailing lists and outgoing mailings.
  11. Work with Health Services and other PacificSource departments to facilitate processes and communications.
  12. Accurately log and maintain program statistics and keep records of various team functions.
  13. Conduct research and gather data/information as requested.
  14. Provide assistance to Wellness Team staff on wellness program offerings as directed.

 

Secondary Functions

Work on designated committees, teams, and task groups, as directed. Assist with any other duties that may be required for efficient functioning of the team and department.     Assist to maintain policies, desktop procedures, and training documentation

 

Supporting Responsibilities:

  1. Meet department and company performance and attendance expectations.
  2. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  3. Perform other duties as assigned.
  4. Practice accountability within the team
  5. Actively participate in process improvement ideas, implementation, and documentation 

Qualifications

Work Experience: Minimum 1 year of experience in the health insurance industry or a medical industry.

 

Education, Certificates, Licenses: High school graduate with at least 2 years of college or equivalent work experience.

 

Knowledge: Ability to define and prioritize problems and manage workload without constant direct supervision. Develops specific goals and plans to prioritize, organize, and accomplish work or task assigned. Ability to interact with people who have various health issues and concerns. Strong Excel and organizational skills with experience in using information systems and computer applications.  Excellent written and verbal communication skills. PC skills including experience with Outlook and Work. Ability to problem solve and work independently.

 

Competencies

Our Values

  • Adaptability
  • Building Customer Loyalty
  • Building Strategic Work Relationships
  • Building Trust
  • Continuous Improvement
  • Contributing to Team Success
  • Planning and Organizing
  • Work Standards

 

 

  • We are committed to doing the right thing.
  • We are one team working toward a common goal.
  • We are each responsible for our customers’ experience.
  • We practice open communication at all levels of the company to foster individual, team and company growth.
  • We actively participate in efforts to improve our communities-internal and external.
  • We encourage creativity, innovation, continuous improvement, and the pursuit of excellence.

 

 

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.

                                                                          

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions.  Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

 

 

PacificSource is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

 

 

 

 

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