Description & Requirements
Maximus is looking for an Outreach Counselor (North Dallas, Texas), this important position provides effective customer services via telephone and in person to clients and community members regarding the selection, enrollment, and eligibility requirements for various Texas Health and Social Services Programs by utilizing excellent, in-depth knowledge of enrollment requirements program information and policies. Identifies, develops, and builds relationships with community, state, and faith-based organizations to enhance presence in the community.

• Interface with clients and refer complaints or inquiries to appropriate departments, agencies, advocates, or client representatives.
• Stay updated on managed care relevant to supported client programs.
• Adhere to processing guidelines, protocols, and contract requirements for complaint processing and handling PHI/PII.
• Assist consumers in health plan enrollment, disenrollment, and transfers when necessary.
• Fulfill assigned duties directed by the Complaint Unit Supervisor or Project Management.
• Meet performance standards outlined in the annual criteria and bonus template for the position.
• Address complex customer service inquiries and problems over the telephone, noting consistent issues for resolution.
• Potentially respond to email inquiries.
• Prioritize customer service as the primary function, handling non-routine calls requiring deviation from standard procedures.
• Manage situations needing adapted responses or extensive research based on customer needs.
• Utilize computerized systems for tracking, information gathering, and troubleshooting.
• Handle escalated or unresolved calls from less experienced representatives.
• Tackle moderately difficult assignments, exercising judgment in issue resolution and recommending solutions.
• Conducts outreach, including phone calls, home visits, and community presentations in the field in accordance with project policy and procedures (50% of the time). Solely responsible for a specific geographic area and related tasks for that area. Travels independently using proper safety precautions.
• Conducts one-on-one and group outreach presentations to recipients and community members within a specific territory or initiative. The work environment varies and is mobile.
• Presents program education and enrollment options to recipients to encourage recipient action. Presents managed care options to recipients and assists them in using their health care and dental plans and community resources as needed.
• Identifies, develops, builds, and maintains positive relationships with county staff, state agencies, and community/faith-based groups to enhance presence in the community.
• Retrieves, researches, and analyzes data from multiple databases to answer client concerns and completes direct data entry into designated internal automated systems in accordance with EB Project policies and procedures.
• Identifies issues, problem-solves, and escalates unresolved issues and concerns to management immediately and regularly.
• Establishes and maintains knowledge of the community and participates in community events, health fairs, and other activities as needed.
• Multi-tasks in several computer applications at once while holding a conversation with client. Responsible for documenting activity in automated systems and reporting outcomes on a daily/ weekly basis. Responsible for ensuring confidentiality of client information.
• Uses customer service skills to adapt to situations and deal with clients face-to-face.
• Willingness to work a flexible schedule including weekends and evenings.
• Assists other Outreach Counselors and other team members with management and completion of daily duties to ensure compliance with contract standards and requirements.
• May be required to wear personal protective equipment (PPE) when having client in-person interaction for precautionary measures
• Provide customer service inbound support via telephone when needed to assist the EB Call Center department
• Performs other duties as may be assigned by managemen