Care Specialist

Health New England • Springfield, MA

399d

About The Position

The Care Specialist at Health New England is responsible for overseeing the daily workload of Care Coordinators within the Care Management Department. This role requires effective technical and decision-making skills to guide the team in providing efficient assistance to HNE members. The Care Specialist will ensure adherence to HNE policies and procedures while acting as an expert in care coordination across all lines of business.

Requirements

• High School diploma or equivalent (associates degree preferred).
• More than 3 years of progressively responsible experience in a medical administrative role.
• Experience with and/or specific training in medical terminology.
• Some experience in a lead capacity preferred.
• Excellent computer skills, including EMR and Microsoft Office products.
• Typing speed and accuracy.
• Knowledge of VISIO.
• Problem solving, organizational, and prioritizing skills.
• Ability to effectively interact with a multi-cultural membership.
• Excellent verbal and written communication skills (Bilingual preferred).
• Strong teamwork skills.

Nice To Haves

• Bilingual proficiency.

Responsibilities

• Oversee daily workload of Care Coordinators within the Care Management Department.
• Adjust daily workflows for the team based on volume and staffing needs.
• Coordinate Care Managers' and Social Workers' Referrals Queue.
• Provide insights to assist the Integrated Care Supervisor in creating productive workflows.
• Track and order educational materials for the department.
• Support orientation and education for Care Coordinators.
• Present at meetings as appropriate.
• Initiate outreach and screening for case management and disease management programs.
• Review MBHP reports and refer members to HFI as appropriate.
• Assess High Cost/Utilizer lists and identify members for CCM High or DM Programs.
• Document assessments and outreach attempts in Aerial as per HNE policies.
• Manage CM Referrals from fax press.
• Assist Care Coordinators as necessary.
• Perform Care Coordinator responsibilities including BeHealthy Maternity Program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED