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Care Management Support Coordinator II
2 months ago
*Description:* Position Purpose: Supports 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. * Education/Experience:* Requires a High School diploma or GED Requires 1 - 2 years of related experienceProvides 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 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 working knowledge of assigned health plans 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 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 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 Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health SDOH needs Performs other duties as assigned Complies with all policies and standards Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):
- Call Center/ Sales Rep making outbound calls supporting Care management Team for CA Market
- Fast Paced Call Center -making outbound calls to existing members.
- Calling existing members and discussing member’s care/ medical reasons for members to sign up for the program.
- Enrolling members into Care Management program
- Production/Sales based role-They will be monitored on the number of members they sign up for program
- Making a minimum of 60 calls per day in a fast paced environment
- Data Entry into True Care
- Ability to navigate multiple systems.
- Excel exp preferred for basic reporting.
- Healthcare experience required
- Call Center Experience Required
- Sales experience highly preferred ability to make sale pitch to existing members
- Role may change at some point-must be open to change and flexible on types of calls they are making(depends on need of business) they will remain on the phones but the types of calls they handle can vary.
- SALES highly preferred
- Bilingual in Spanish a plus
