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Fallon Health Member Outreach Representative - Great Outbound Call Center Role - Spanish-speaking highly desirable! in Worcester, Massachusetts


About Fallon Health

Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit


Under the direction of the Market Research Manager, supports Fallon by making Welcome/Outreach calls to members and/or survey calls to members or providers. Handles confidential patient/member information. Uses strong verbal communication skills and demonstrates excellent telephone communication skills. Understands the importance of leaving a positive impression on any member with whom they come into contact. When necessary, assists member through the creation of formal research cases.

The shift for this position is 8:30 am to 5:00 pm Monday - Friday, 40 hours/week.


Primary Job Responsibilities:

  • Exhibits courtesy, compassion, empathy, and respect in all outbound communications with members and providers. Utilizes proper judgment in handling difficult or unusual calls.

  • Responsible for learning and keeping current with Fallon products, policies and procedures.

  • Responsible for documenting the results of all outbound calls using an electronic or written form.

  • Makes Welcome/Outreach telephone calls to Fallon members providing product knowledge, customer assistance, and problem solving.

  • Administers member telephone surveys. Working from a script, asks both open-ended and closed ended questions of members in order to capture information such as why the member joined Fallon, how satisfied the member is with Fallon and why the member left Fallon.

  • Maintains the highest degree of member/patient confidentiality.

  • Works both as a team member and as an individual depending on assigned project.

  • Works on special projects and other tasks such as focus group recruitment and data entry as assigned by the Market Research Managers or executive staff.

  • Assists Fallon members by creating formal research cases. When necessary, is responsible for properly documenting member issues and entering information into a specialized company database.


Education : High School Diploma

Experience: Minimum of one year Customer Service experience in a call center environment, computer skills.

Spanish-speaking highly desirable.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.


Location US-MA-Worcester

Posted Date 3 weeks ago (8/28/2020 9:59 AM)

Job ID 6055

# Positions 1

Category Customer Service