Integrated Care Program Specialist

Health Plan of San Mateo • CA

82d

About The Position

This role is responsible for providing lead administrative support and assistance to the Integrated Care Management team. Primary focus is responding to integrated care management requests, data entry of medical records, data reporting, member screening and outreach, maintenance of tracking census and reports, and assistance in linking members to appropriate benefits and services.

Requirements

• High school diploma or GED required.
• One year of managed care experience, preferably in Care Coordination.
• Experience working with the health needs of the population served.
• At least one year of direct Care Coordination experience.

Nice To Haves

• College level courses in health care.
• Experience as a Medical assistant or Licensed Vocational Nurse.
• Bilingual skills highly preferred, particularly Spanish, Tagalog or Chinese.

Responsibilities

• Process ICM Care Management team requests for member outreach, screening, education, referrals and follow ups.
• Maintain and update the ICM Resource Guide, job aids, workflows, and other program materials to support ICM operations.
• Maintain daily oversight of ICM SDP tickets via maintenance of ICM fax folders, emails and phone requests.
• Assist members with appointments for specialists, educational classes, and transportation.
• Work with healthcare providers to coordinate and share plans of treatment.
• Perform data entry and data reporting and maintain updates for member information in ICM case management system.
• Support with onboarding of all new hire ICM staff.
• Assist ICM staff with meeting the care coordination needs of members.
• Develop tracking reports related to census, program and service monitoring and utilization.
• Participate in team meetings taking meeting minutes as needed.
• Perform other duties as assigned.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 101-250 employees