Team Lead, Care Management Support Coordinator

Centene Corporation•Remote-PA, PA

2d•$20 - $35•Hybrid

About The Position

Works with 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 and documents member records in accordance with current state and regulatory guidelines. Successful candidates in this role are critical thinkers, organized, action-oriented, have strong communication skills (verbal and written), flexible with business needs, quick learners, comfortable presenting findings and data to People Leaders and peers, and works well under pressure to handle escalations and tight deadlines. This role assists People Leaders with data reporting on a weekly basis (up to 50%) and will need to have moderately strong Excel skills (i.e. data extraction, creating pivot tables, conditional formatting, etc) and/or curious to learn more with Gen AI tools.

Requirements

Requires a High School diploma or GED (minimum)
2 - 4 years of related experience
4+ years of experience processing healthcare or insurance authorizations and coordinating services for members with access to Medicaid Long-Term Services and Supports (LTSS)
Strong problem-solving skills
Communication skills (i.e. be professional, customer-centric, inclusive, and tactful)
Strong organizational and time management skills are required
Ability to adapt to changing business needs with openness, flexibility, and professionalism
Must be comfortable presenting findings clearly and concisely to various stakeholders
Moderately strong Excel skills (i.e. data extraction, creating pivot tables, conditional formatting, etc)

Nice To Haves

Curious to learn more with Gen AI tools

Responsibilities

Provides 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 experienced support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
May apply in-depth knowledge of assigned health plan(s) activities and resources
Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols
Applies in-depth knowledge of care management support activities including care plans and community resources
Supports 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 requests and inquiries to management
Documents and maintains 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
May support training of new hires
Performs other duties as assigned
Comply with all policies and standards