Care Management Support Coordinator IV - Team Lead

Centene Corporation•San Antonio, TX

2d•$23 - $39•Hybrid

About The Position

Leads the care management team on 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 for care plan-related questions and documents member records in accordance with current state and regulatory guidelines. Leads and guides member 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 ongoing support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service Applies advanced knowledge of assigned health plan(s) activities and resources Serves as the front-line support on various highly complex member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols Works with care management team to identify process improvements on administrative care management activities and provide recommendations Applies advanced knowledge of care management support activities including care plans and community resources Performs team 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 Works with care management team on escalating very complex requests and inquiries to management Documents and maintains all 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 Contributes to the development of education and training programs Other duties or responsibilities as assigned by people leader to meet the member and/or business needs Performs other duties as assigned Complies with all policies and standards

Requirements

High School diploma or GED
4+ years of related experience

Nice To Haves

2+ years of care coordination experience supporting diverse populations, including children, adolescents, adults, and older adults
Experience with, or working knowledge of, PSON and MNSF workflow processes
2+ years of experience with STAR Health, STAR Kids, STAR+PLUS, Duals, Medicaid, and/or Medicare programs
Strong documentation skills with demonstrated audit performance in TruCare Cloud
Demonstrated professionalism, diplomacy, adaptability, and attention to detail in a fast-paced environment
Proficiency with Microsoft Office Suite, including Excel, OneNote, PowerPoint, and Outlook
Excellent problem-solving, organization, time management, and communication skills
Ability to adapt quickly to changing business priorities while maintaining flexibility and professionalism
Ability to communicate data, findings, and recommendations clearly to cross-functional stakeholders
Texas DFPS background check

Responsibilities

Leads the care management team on 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 for care plan-related questions and documents member records in accordance with current state and regulatory guidelines.
Leads and guides member 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 ongoing support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service.
Applies advanced knowledge of assigned health plan(s) activities and resources.
Serves as the front-line support on various highly complex member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols.
Works with care management team to identify process improvements on administrative care management activities and provide recommendations.
Applies advanced knowledge of care management support activities including care plans and community resources.
Performs team 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.
Works with care management team on escalating very complex requests and inquiries to management.
Documents and maintains all 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.
Contributes to the development of education and training programs.
Other duties or responsibilities as assigned by people leader to meet the member and/or business needs.
Performs other duties as assigned.
Complies with all policies and standards.