Care Advocate - Bilingual (Yakima Area)

This position is primarily remote, however it will require occasional travel to Clinics in the Yakima area. 

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to apply an equity lens to all our work. 
• Reduce health disparities. 
• Become an anti-racist organization 
• Create an equitable work environment. 

About the Role

Responsible for supporting CHPW’s Dual Special Needs Plan (DSNP) and Medicare Advantage (MA) members in navigating benefits and health care systems to promote optimal health and a positive experience with the Health Plan.  This role conducts welcome calls and Health Risk Assessments to new members, as well as routine outreach to promote health screenings and engage members in the Care Management programs.  Position also serves as a primary contact for the Care Teams, receiving inbound calls from members to resolve members needs or triage to the appropriate CHPW staff or team.  This role is an active participant of the Medicare Care Management Care Teams.

To be successful in this role, you:

• Have three (3) years in administrative, customer service, and/or patient services coordination (referrals, appointments, etc.) in a healthcare services field required or,
• Have one (1) year as a Medical Assistant or related field.
• Are certified through an accredited medical assistant program, Allied Health education program, or other related certification, preferred
• Have working knowledge of medical terminology, electronic medical records, and healthcare process preferred.

Essential functions and Roles and Responsibilities:

• Provides telephonic outreach to identified members to complete Welcome Calls and Health Risks Assessments.
• Educates members on the Medicare Care Teams and how to utilize the team for support.
• Educates members on routine health screenings and requirements of the Dual Special Needs Plan program (i.e., face to face visits requirements, health risk assessments, individualized care plans, and interdisciplinary care team meetings) and how to engage with the Medicare Care Team.
• Assist members in navigating CHPW benefits and internal programs by providing education and actively connecting the member to the appropriate CHPW team to resolve the member’s needs.
• Outreach to identified members to assist in closing care gaps and/or making appointments with their community providers and/or in-home providers.
• Provides telephonic triage of inbound member, family, and/or caregiver calls; triages to appropriate staff or resolves issues directly.
• Proactively support members who are in crisis and activate the Crisis Caller in Distress process.
• Receives warm handoffs from the CHPW Welcome Call team or Pharmacy department for Medicare members that need to complete a Health Risk Assessment or access their Care Team.
• Provides educational material as directed by the Medicare Care Team via telephone and/or mail/texting to members.
• Participates in the Medicare Care Team meetings and workflows to support assigned population of members.
• Prioritize, organize, and complete daily work both independently and collaboratively as part of a team.
• Conducts surveys to gauge overall satisfaction with the Plan.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

• Ability to speak Spanish or another language preferred.
• Ability to meet scheduled deadlines, manage time, organize, and prioritize work.
• Effective verbal and written communication skills.
• Ability to use Microsoft Office products such as Outlook, Word, and Excel.

Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn’t perfectly check every box in the job description, we encourage you to apply anyway.

As part of our hiring process, the following criteria must be met:

• Complete and successfully