Call Center (San Antonio, TX)

An employer is seeking a Care Transition Advocate (CTA)to work in an enterprise level environment in the healthcare industry. This call center is a one stop shop for anything a patient could be having issues with. You would be getting calls based of CAHPS (Consumer Assessment of Healthcare Providers and Systems) and HOS scores (Health Outcomes Survey). You would provide some of the clinical counseling for some of the HOS measures. You will help close the gaps with appointment scheduling, test, referrals, complaints, escalations, medication adherence measures, refills etc. Anything it takes a patient from being unhappy to as happy as we can get them. The call range can take 10 min to a couple of hours whether that’s connecting the patients to their health plan, their providers office, their nurse, their home health, outside resources to help with social determinacies of health, and APS.

• Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Outbound calls are made primarily using an auto dialer requiring precision to detail and adaptability to type of response needed.
• Comfortable working in high call volume call center environment
• Completes calls/assignments and productivity weekly and monthly standards are met.
• Provides excellent customer service by serving as a resource to all internal and external customers.
• Must be able to multi-task using multiple applications to provide accurate and responsive information to the member
• Must be able to pivot throughout the day to perform multiple duties
• Receives and responds to escalated inquiries from all communication venues: e.g., task queues, fax portal, claim queue, department documentation platform.
• Provides clerical and/or administrative support to clinical staff and managers for special studies, projects, and reports
• Documents the provider or member's record with accurate information obtained on the call.
• Responsible for completing specialized assigned tasks/calls
• Ability to work independently, with some supervision and direction from manager
• Engages PCP and clinic staff in developing strategies to close quality gaps.
• Supports and assists PCPs/clinics with quality data collection.
• Demonstrate excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers, managers, supervisors and leads.
• Demonstrate a high degree of professionalism to always include personal conduct and appearance
• Ability to always maintain strict confidentiality with members while abiding by all HIPPA and compliance requirements
• Compliance with all organizational policies regarding ethical business practices
• Must adhere to all department policies and procedures
• Adheres to assigned schedule including log in/out time, breaks and lunches. Excellent attendance is a must.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

• High School Diploma or GED
• 2+ year in a pharmacy/medical/healthcare setting
• 1 year of administrative support experience
• 1 year experience working with all Microsoft Office products (Word, Outlook. Excel, Teams, etc.)
• 1 year experience with Pharmacy and/or medical terminology knowledge base
• 1 year call center experience
• Knowledge of basic system troubleshooting

• Certified/Registered Pharmacy Technician or Certified Medical Assistant training or certification
• 3+ years of experience in a pharmacy setting or physician’s clinic or hospital
• Prior HEDIS/STAR experience or participation with similar regulatory reporting.
• Call documentation platform experience
• Online softphone experience

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.