Care Management Support Professional

Humana • Norcross, GA

240d • $45,400 - $61,300 • Remote

About The Position

The Care Management Support Professional 1 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of patients' needs and requirements to achieve and/or maintain optimal wellness state by guiding patients'/families toward and facilitate interaction with resources appropriate for the care and wellbeing of the patient. The Care Management Support Professional work assignments are often straightforward and of moderate complexity. Work Schedule: Full-time/40 Hours/M-F Job Type: Care Management Support Professional 1 Line of Business: CenterWell Primary Care Anywhere.

Requirements

• Bachelor's degree or equivalent years of relevant experience.
• Minimum of 3 years' experience in Provider Relations, Operations, Customer Service, Logistics, and/or Project Coordination.
• 2 years of demonstrated leadership capabilities.
• Exceptional reporting, forecasting, and presenting capabilities.
• Experience with new hire training, onboarding, shadowing coordination, and inventory management.
• Experience working with patient electronic medical records (EMR).
• Minimum of 1 - 3 years of Microsoft technical experience.
• Knowledge of Word, Excel, and Outlook.
• Proficiency in using scheduling and business management software.
• Well-versed in quality and process improvement initiatives.
• Dedication to maintaining high-quality service and performance.
• Ability to work well in a fast-paced, dynamic environment.
• Excellent verbal and written communication skills.
• Ability to work cross-functionally and communicate effectively.
• Excellent attention to detail, interpersonal, negotiation, organizational, and conflict resolution skills.
• Ability to act with integrity, professionalism, and confidentiality.

Nice To Haves

• Master's degree in business or a related field.
• Microsoft Access and Microsoft Teams experience.
• Knowledge of HEDIS measures.
• Knowledge of value-based care and primary care.
• When I Work (WIW) software experience.

Responsibilities

• Understand own work area professional concepts/standards, regulations, strategies and operating standards.
• Make decisions regarding own work approach/priorities and follow direction.
• Manage multi-pod capacity management to ensure efficient resource allocation.
• Manage scheduling and utilization to enhance patient and provider experience.
• Conduct regular audits to maintain data accuracy and operational excellence.
• Expedite routing configuration for efficient patient/provider interactions.
• Handle and prioritize provider scheduling requests.
• Oversee key performance indicators, focusing on reducing cancellations and appointment wait times.
• Provide dotted line management to Care Management Assistants (CMAs) including delegation of responsibilities.
• Manage and resolve contact center escalations in a timely and efficient manner.
• Maintain oversight of When I Work (WIW) platform scheduling, implement necessary modifications, and perform audits.
• Triage and resolve operational issues, routine patient complaints, and provider escalations related to routing or scheduling.
• Hold and attend care management team huddles with the Care Management Assistants (CMAs) to facilitate communications and problem-solving initiatives.
• Oversee care management team email mailboxes and ensure timely responses.
• Conduct new hire training, onboarding, and shadowing coordination for new team members.
• Manage inventory, including ordering of necessary supplies.
• Lead quality initiatives to improve market performance, focusing on patient and provider satisfaction.

Benefits

• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, volunteer time off.
• Paid parental and caregiver leave.
• Short-term and long-term disability.
• Life insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree