Health Risk Assessor
Job Summary:
The Outbound Health Risk Assessor is responsible for conducting outbound calls to health insurance members to complete Health Risk Assessments (HRAs). This role focuses on gathering accurate health-related information, educating members on wellness resources, and ensuring a positive, compliant, and professional member experience. The ideal candidate is confident in outbound calling, empathetic, detail-oriented, and experienced in healthcare or insurance-related environments.
Key Responsibilities:
Outbound Member Engagement
Make outbound calls to health insurance members to complete Health Risk Assessments (HRAs).
Verify member identity following HIPAA-compliant verification procedures.
Build rapport and communicate with empathy, professionalism, and cultural sensitivity.
Encourage member participation while maintaining a non-sales, educational approach.
Health Risk Assessment Administration
Ask standardized HRA questions accurately and objectively.
Document member responses precisely in CRM, EMR, or client systems.
Identify basic health risks and flag responses according to client protocols (no diagnosis or medical advice).
Escalate urgent or sensitive responses following established procedures.
Data Accuracy & Documentation
Maintain complete, accurate, and timely documentation of all interactions.
Follow scripts, workflows, and quality assurance guidelines.
Ensure compliance with data privacy and security standards at all times.
Compliance & Quality
Adhere strictly to HIPAA, PHI handling standards, and client-specific compliance requirements.
Maintain required call quality scores, productivity targets, and completion rates.
Participate in coaching, QA reviews, and training sessions as required.
Member Experience & Retention Support
Provide clear explanations of wellness programs, preventive care benefits, or next steps when applicable.
Address basic member questions or route concerns to appropriate departments.
Maintain a courteous, respectful, and patient-centered communication style.
Required Qualifications:
Minimum 1 year experience in healthcare, health insurance, call center, or patient outreach roles.
Strong outbound calling experience (cold or warm calls).
Excellent verbal communication skills in English (neutral accent preferred).
Comfortable discussing general health and lifestyle topics professionally.
High attention to detail and strong documentation skills.
Ability to follow scripts, workflows, and compliance guidelines.
Reliable high-speed internet and quiet remote work environment.
Preferred Qualifications:
Prior experience conducting Health Risk Assessments (HRA).
Familiarity with U.S. health insurance, Medicare, Medicaid, or Managed Care Organizations (MCOs).
Experience with CRM or EMR systems.
Knowledge of basic wellness, preventive care, or population health concepts.
Bilingual skills (Spanish or other languages) are a plus.
Key Skills & Competencies:
Empathy and active listening
Professional phone presence
Time management and productivity
Compliance awareness
Data accuracy and confidentiality
Problem-solving and escalation judgment
Performance Metrics (KPIs):
HRA completion rate
Call volume and productivity targets
Quality assurance scores
Documentation accuracy
Member satisfaction feedback
Compliance Notice:
This role does not provide medical advice, diagnosis, or treatment. All activities must comply with HIPAA, client policies, and Avocado VA security standards.
Note:
For Vietnamese-English Bi-Lingual Rep, the applicant must speak,read,write fluently in both languages.
For Spanish-English Bi-Lingual Rep, the applicant must speak,read,write fluently in both languages.