Role Description In this role, you will assist in resolving patient/member concerns, providing appropriate education/instruction and maintaining patient/member satisfaction by providing the highest level of clinical support. You will: - Assist and educate patients/members about available services through motivational interviewing, problem solving, and interpreting complex clinical problems. - Research information, contact providers, and provide patient/member information. - Assist patients/members with social determinants of health, special needs, and/or crisis situations. - Advocate for patients/members who are incapacitated or unable to communicate effectively. Job Duties: - Serve as the primary contact for Enhanced Member Supports Unit, Behavioral Health, and network for patients/members/providers. - Assess all clinical issues and concerns to assure accurate information is provided promptly. - Manage crisis situations with patients/members and triage appropriately. - Provide assistance with concerns related to social determinants of health. - Complete resolution for all patient/member/provider concerns and inquiries. - Provide daily support and direction to patient/member/provider services staff. - Obtain data on callers’ needs for use in monthly statistical and activity reports. - Communicate and coordinate with the appropriate internal department to resolve issues. - Collect and record data on special needs organizations, facilities, and services. - Prepare, generate, and appropriately disseminate letter communications to patients and members. - Provide training within the team as needed. - Explore covered benefits and community resources as applicable by line of business and product design. - Provide team building resources to help direct peers to appropriate policies and procedures. - Complete outbound calls to patients/members/providers to resolve complex eligibility issues. - Navigate multiple computer programs while assisting patients/members/providers. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. Qualifications - Bachelor's Degree in a related field of study (Social Work, Healthcare Administration, Psychology, Public Health, Human Services, or a related healthcare/behavioral health field). - Minimum of 1 year of related work experience. Requirements - Bachelor's Degree in a related field of study (Required). - Minimum of 1 year of related work experience (Required). Benefits - Full benefits (health, dental, and vision) starting on day one. - Three medical plan choices, including an expanded network for out-of-area employees and dependents. - Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA) with employer contribution. - Company-paid life insurance, short-term disability, and long-term disability coverage. - 401(k) plan that includes automatic Geisinger contributions. - Generous paid time off (PTO) plan that allows you to accrue time quickly. - Up to $5,000 in tuition reimbursement per calendar year. - MyHealth Rewards wellness program to improve your health while earning a financial incentive. - Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay, and a free Care.com membership with discounted backup care for your loved ones. - Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care; Access free legal guidance, mental health visits, work-life support, digital self-help tools and more. - Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life, and pet and legal insurance.