Care Management Support Coordinator II - J01003

TEKsystems•Tampa, FL

3d•$22 - $24•Remote

About The Position

Position Purpose: Supports administrative care management activities including performing outreach answering inbound calls 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. 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 Performs other duties as assigned Complies with all policies and standards

Requirements

Customer Service
Medical Insurance
Communication skills
Must have great organizational skills and easily coachable
Required: HS Diploma
Must haves: Call center experience, Medical Insurance experience, Customer service, Problem solving skills.
Not having a quiet place to take live calls and poor internet quality/speed.

Nice To Haves

Trucare experience and phone system experience

Responsibilities

Supports administrative care management activities including performing outreach answering inbound calls 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.
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
Performs other duties as assigned
Complies with all policies and standards