Care Management Support Coordinator II - J01003

TEKsystems•Boulder City, NV

1d•$23 - $23•Remote

About The Position

Care Management Support Coordinator II Description Remote – candidates MUST reside in MST/PST Position Purpose: Supports administrative care management activities including performing outreach, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines. Additional staff needed due to business fluctuation HIGH VOLUME Outbound calls to members, providers, and staff • Call Center making outbound calls supporting Care management Team • Fast Paced Call Center -making outbound calls to existing members. • Calling existing members and discussing member’s care/ medical reasons for members to sign up for the program. • Enrolling members into Care Management program • Production/Sales based role-They will be monitored on the number of members they sign up for program, call volume and caseload • Making a minimum of 60 calls per day in a fast-paced environment • Data Entry into True Care • Ability to navigate multiple systems. • Excel exp required for basic reporting. • Healthcare experience required! • Call Center Experience Required • Sales experience highly preferred ability to make sale pitch to existing members • Role may change at some point-must be open to change and flexible on types of calls they are making (depends on need of business) they will remain on the phones but the types of calls they handle can vary. Provides outreach to members via phone to support with care plan next steps community or health plan resources questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service May apply working knowledge of assigned health plans activities and resources Serves as the front-line support on various member and/or provider inquiries requests or concerns which may include explaining care plan procedures and protocols Supports member onboarding and day-to-day administrative duties including sending out welcome letters related correspondence and program educational materials to assist in the facilitation of a successful member/provider relationship Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health SDOH needs

Requirements

HIGH VOLUME Outbound calls to members, providers, and staff
Call Center making outbound calls supporting Care management Team
Fast Paced Call Center -making outbound calls to existing members.
Calling existing members and discussing member’s care/ medical reasons for members to sign up for the program.
Enrolling members into Care Management program
Production/Sales based role-They will be monitored on the number of members they sign up for program, call volume and caseload
Making a minimum of 60 calls per day in a fast-paced environment
Data Entry into True Care
Ability to navigate multiple systems.
Excel exp required for basic reporting.
Healthcare experience required!
Call Center Experience Required

Nice To Haves

Sales experience highly preferred ability to make sale pitch to existing members
Role may change at some point-must be open to change and flexible on types of calls they are making (depends on need of business) they will remain on the phones but the types of calls they handle can vary.

Responsibilities

Supports administrative care management activities including performing outreach, and scheduling services.
Serves as a point of contact to members, providers, and staff to resolve issues
Documents member records in accordance with current state and regulatory guidelines.
Provides outreach to members via phone to support with care plan next steps community or health plan resources questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service
Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
Serves as the front-line support on various member and/or provider inquiries requests or concerns which may include explaining care plan procedures and protocols
Supports member onboarding and day-to-day administrative duties including sending out welcome letters related correspondence and program educational materials to assist in the facilitation of a successful member/provider relationship
Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health SDOH needs