Care Management Support Coordinator II

Centene Corporation•Remote-TX, MI

2d•$18 - $28•Remote

About The Position

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. This role supports Medicaid LTSS members who are age 21 and older. Successful candidates are detail-oriented, flexible, quick learners, and comfortable using web-based systems and CMS platforms.

Requirements

Requires a High School diploma or GED
Requires 1 – 2 years of related experience
at least 2 years of experience making outbound calls to members or providers in a remote call center environment
2 years of experience processing healthcare or insurance authorizations and coordinating services for members or providers
detail-oriented, flexible, quick learners, and comfortable using web-based systems and CMS platforms

Nice To Haves

2+ years supporting adults age 21+ receiving Long-Term Services and Supports (LTSS)
2+ years of member or provider outreach in a fully outbound call environment
2+ years processing healthcare/insurance authorizations and coordinating member or provider services

Responsibilities

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 plan(s) 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
Comply with all policies and standards