About The Position
Job Summary: The Field Operations Specialist is responsible for conducting and coordinating home visits for the care management team, and responsible for the clerical, administrative, customer service and coordination of activities to support care management. Essential Functions: Schedule and travel to members’ homes to conduct in-home care management visits. Support the provision of care plans by assisting Nurse Care Managers with member interactions and take authorizations from Nurse Care Manager for processing. Answer incoming calls, place outgoing calls as requested and/or review member care management survey results identifying issues requiring follow-up. Coordinate services, take requests for services, assist Nurse Care Manager in placing authorized services and speaking to members. Assist members in navigating the Health Plans process by phone and in person visits. Establish and maintain relationships acting as the liaison among members, clinical staff and external entities. Perform any other job related duties as requested.
Requirements
- High School or GED required
- Experience using multiple languages in a professional capacity required
- Proficient in Microsoft Office Suite to include Word, Excel and PowerPoint
- Fluency (speaking, reading, writing) in English and Spanish
- Strong written and verbal communication skills
- Effective listening and critical thinking skills
- Strong interpersonal skills and high level of professionalism
- Ability to define problems, collect information and establish facts
- Ability to work independently and within a team environment
- Ability to develop, prioritize and accomplish goals
- Knowledge of applicable Federal, State and Local regulations as it applied to required job functions
- Must have valid driver's license, vehicle and verifiable insurance.
- Employment in this position is conditional pending successful clearance of a driver’s license record check.
- Influenza vaccination is a requirement of this position.
Nice To Haves
- Associates degree preferred
- Medical terminology experience is strongly preferred
Responsibilities
- Schedule and travel to members’ homes to conduct in-home care management visits.
- Support the provision of care plans by assisting Nurse Care Managers with member interactions and take authorizations from Nurse Care Manager for processing.
- Answer incoming calls, place outgoing calls as requested and/or review member care management survey results identifying issues requiring follow-up.
- Coordinate services, take requests for services, assist Nurse Care Manager in placing authorized services and speaking to members.
- Assist members in navigating the Health Plans process by phone and in person visits.
- Establish and maintain relationships acting as the liaison among members, clinical staff and external entities.
- Perform any other job related duties as requested.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
