Community Outreach Technician

GENERAL DESCRIPTION: The Community Outreach Technician provides administrative and field support in addressing the non-clinical needs of policyholders. This role involves assisting in the care management process by gathering information on psychosocial needs, general health, and living conditions. Collaborates with the interdisciplinary team to identify priority needs for high-risk policyholders and facilitates coordination of community-based non-clinical services aligned with policyholder preferences. Supports clinical staff by locating and engaging policyholders, and plans daily work activities to efficiently complete assessments, coordination, and follow-up within established timelines. ESSENTIAL FUNCTIONS: • Coordinates referrals and arrangements with community resources for non-clinical services and conducts follow-up as needed. • Processes and manages internal clinical staff and interdepartmental referrals using electronic systems. • Conducts telephonic and home visit activities (including Vieques and Culebra) to policyholders participating in care management programs to gather information on psychosocial needs, physical status, barriers to care, and medication inventories. • Documents, updates, and closes non-clinical cases and care plan-related information in electronic systems according to established guidelines. • Supports the care planning process by collecting, organizing, and documenting relevant policyholder information for review by clinical staff. • Assists in implementing interventions to coordinate non-clinical services aligned with policyholder needs, preferences, and available community resources. • Educates and guides policyholders, families, and caregivers on community resources, medical plan benefits, and care options to support informed decision-making. • Maintains and updates a centralized database of community resources, including government, nonprofit, and community organizations. • Identifies and coordinates referrals for mental health services and other specialized needs based on collected information and established protocols. • Identifies barriers (visual, hearing, language, or functional) and coordinates appropriate support services, including Customer Service referrals when required. • Participates in Complex Interdisciplinary Team meetings to provide input on social and non-clinical aspects and support implementation of care plans and recommendations, and/or facilitates implementation of the committee’s recommendations. • Coordinates urgent and emergency referrals, collaborates with care managers and team members, manages required documentation (e.g., Authorization for Use and Disclosure of Health Information), and escalates issues to supervisors as needed. • Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. • May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. MINIMUM QUALIFICATIONS: Education and Experience: Associate’s degree and/or sixty to sixty-four (60-64) university credits equivalents in Health, Social Sciences, or related areas. At least one (1) year of experience in customer service or related areas, preferably working within the Health Insurance Industry. “Proven experience may be replaced by previously established requirements.” Certifications / Licenses: A valid driver's license in the Commonwealth of Puerto Rico is required. Other: Availability to travel throughout the Island. Languages: Spanish – Intermediate (comprehensive, writing and verbal) English – Intermediate (comprehensive, writing and verbal)