Manager, Svcs Coord Advocate
2 weeks ago
JOB SUMMARY
The Manager, Service Coordination Advocate at Community Health Choice is a highly motivated and experienced manager with contact center experience. This role oversees the STAR+PLUS program and leads a team of Service Coordination Advocates.
The Manager plays a pivotal role in coordinating the administrative functions of the care management assistant team, ensuring the smooth operation of client care processes and the efficient delivery of services. Responsibilities include providing direction and support to the assistants, facilitating effective communication within the team and with other departments, and implementing strategies to enhance productivity and quality of care. The Manager collaborates with senior management to develop and implement policies, procedures, and initiatives aimed at improving client outcomes and operational efficiency.
Additionally, the Manager serves as a liaison between the service coordination team and external stakeholders, fostering positive relationships and promoting a culture of excellence and compassion in service delivery. The ideal candidate will have a strong background in health care management, care coordination, and an in-depth understanding of the STAR+PLUS program requirements.
JOB SPECIFICATIONS AND CORE COMPETENCIES
- Staff Management and STAR+PLUS Service Coordination:
- Manage staff handling STAR+PLUS Service Coordination Hotline calls, supporting members and providers with initial assessments, scheduling and rescheduling, HRA's, requests for Service Coordinators, and other benefits inquiries and authorization status updates.
- LTSS Knowledge and Care Management System:
- Maintain a working knowledge of LTSS, waivers, Community First Choice (CFC) services, and accurately enter required information into the designated care management system (OICS), adhering to departmental and organizational policies and procedures.
- Complex Member and Provider Concerns:
- Utilize critical thinking skills to resolve complex member and provider concerns.
- Professional Behavior and Interpersonal Skills:
- Maintain a professional behavior and exhibit excellent interpersonal skills.
- Collaborative Work:
- Work collaboratively with coworkers and the Medical Affairs Team to deliver member/provider services that meet or exceed expectations.
- Perform other duties as assigned.
QUALIFICATIONS:
- Education/Specialized Training/Licensure: Bachelors Degree or 4 years of experience in lieu of degree required.
- Work Experience (Years and Area): 5 years of related experience with Bachelors Degree. 9 years of experience in lieu of degree.
- Cross-functionality in claims, authorizations, benefits, and eligibility.
- STAR+PLUS Experience and understanding LTSS, Waivers, and Community First Choice (CFC)
- Management Experience (Years and Area): Two (2) years of supervisor experience in health care/health plan, including call center experience.
- Software Proficiencies: Microsoft Office (Word, Excel, Outlook)
Other: Ability to work independently under minimal direction.
Moderate to advanced computer knowledge required.
-
Customer Service Advocate
13 hours ago
Houston, Texas, United States Daniels Sharpsmart Inc Full timeWe are looking to add a Customer Service Representative to support our growth in Houston This role plays a critical part in ensuring our customers' interactions with Daniels Health are seamless - from communicating to scheduling, issue resolution and fact-finding; you will do it allAn essential service provider to Healthcare, Daniels Health was founded with...
-
Web Designer
4 weeks ago
Houston, Texas, United States MSIT Full timeResponsiblties Create schedule and manage social media posts across all platforms. Be a strong advocate for excellent user experience and recommend solutions. Meet established deadlines for assigned projects and proactively inform stakeholders of project status and updates. Identify and improve areas of the website with SEO-rich content. Produce monthly...
-
Scrum Master
2 weeks ago
Houston, Texas, United States Apollose Full timeResponsibilities Help mature processes within the organization maintain and refine capacity planning sprint planning and delivery cadence. Drive process improvements for continuous improvement and continuous delivery pipeline automation as needed by your team. Foster an environment where team members have a voice and freely participate in and advocate for...
-
Customer Service
3 weeks ago
Houston, Texas, United States Docjuris Full timeDocJuris is looking for an experienced Customer Service Associate DocJuris is an AI platform that delivers joy to legal, procurement, and sales teams by cutting contract cycle times and increasing consistency.We provide all our team members with a flexible remote-first work environment while being part of a diverse and empathetic team.If you're excited about...
-
Special Education Teacher Cohort
7 days ago
Houston, Texas, United States Thrive Therapies Group Full timeAdditional opportunities added Applications for the Houston, TX cohort are due May 31st We believe special education teachers are invaluable. You have advanced expertise and experience across the range of learning disorders and differences. You know each child individually. You value their gifts and strengths. You work to make those gifts shine. You...
-
Customer Service Advocate Ii
1 month ago
Houston, United States Harris Health System Full timeCommunity Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: - Medicaid State of Texas Access Reform (STAR) program for low-income children and...
-
Customer Service Advocate Ii
4 weeks ago
Houston, United States Harris Health System Full timeCommunity Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: - Medicaid State of Texas Access Reform (STAR) program for low-income children and...
-
Customer Service Advocate I
3 days ago
Houston, United States Harris Health System Full timeCommunity Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: - Medicaid State of Texas Access Reform (STAR) program for low-income children and...
-
Patient Advocate
1 week ago
Houston, United States Premier Medical Resources Full timePremier Medical Resources is a healthcare management company headquartered in Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career, and to those who seek to...
-
Patient Advocate
3 weeks ago
Houston, United States Premier Medical Resources Full timeJob DescriptionJob DescriptionPremier Medical Resources is a healthcare management company headquartered in Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional...
-
Social Security Disability Advocate
5 days ago
Houston, United States The Peace Group, Inc. Full time**Responsibilities**: - Conduct client intake interviews to assess eligibility for Social Security Disability benefits. - Gather and review medical records, employment history, and other relevant documentation to build strong cases. - Prepare and submit appeals, requests for reconsideration, and other necessary paperwork on behalf of clients. - Represent...
-
Manager Perioperative Svcs
1 week ago
Houston, United States Catholic Health Initiatives Full timeOverview Baylor St. Luke’s Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care neuroscience oncology transplantation and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found...
-
Manager Perioperative Svcs
1 week ago
Houston, United States Unavailable Full timeOverview Baylor St. Luke’s Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care neuroscience oncology transplantation and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found nowhere...
-
Customer Service Advocate
6 days ago
Houston, United States Mazak Corporation Full timeMazak Corporation is looking for a Customer Service Advocate to join the North Central Region at our National Technology. This position is responsible for improving the customer service experience by acting as a liaison between the service team and customers along with supporting the service team internally through the following responsibilities...
-
Director Case Management
5 days ago
Houston, United States Houston Methodist Full timeAt Houston Methodist, the Director Case Mgmt Social Svcs position is responsible for strategy, function and operations of the Case Management & Social Work department. This position is an integrated, interprofessional role which supports caregivers to provide the highest quality, most clinically appropriate care to patients while promoting the most...
-
Manager Perioperative Svcs
2 weeks ago
Houston, Texas, United States CommonSpirit Health Full timeOverview: Baylor St. Luke’s Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care neuroscience oncology transplantation and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found...
-
Member Advocate Team Lead
1 week ago
Houston, United States Members Choice Credit Union Full time**General Job Description** The Member Advocate Team Lead is responsible for providing excellent member service and accurate processing of financial transactions, resolve issues and answer questions for members and associates; to identify and suggest financial services that would fit our member’s financial needs. Provide supervisory duties and assist...
-
Customer Service Advocate I
4 weeks ago
Houston, United States Community Health Choice Full time**Customer Service Advocate I - Community Health Choice** **Job Description** Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid...
-
Member Advocate Team Lead
7 hours ago
Houston, United States Members Choice Credit Union Full timeMembers Choice Credit Union (MCCU) is a full-service member-owned financial cooperative based in Houston, Texas, with an 80-year legacy of serving our members and the community. At MCCU, we are always working to improve as we build upon our vision to create the Credit Union of the future. Our people work collaboratively and support each other to accomplish...
-
Supervisor Nutrition Svcs
1 month ago
Houston, United States Baylor St Luke's Medical Center Full time**Overview** Baylor St. Luke’s Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care neuroscience oncology transplantation and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found...
-
Student Success Advocate I- College of Medicine
2 weeks ago
Houston, United States University of Houston Full timeSummary Provides integrated career counseling, academic advising and educational counseling for undeclared and other targeted Medical Students served by our Student Affairs, Admissions, & Outreach department. Develop strategic plans to enhance student learning and empower students to successfully meet degree requirements and persist to graduation. Job Duties...
-
Rep, Customer Svc
4 weeks ago
Houston, United States Kirby Corporation Full timeOverview: Facilitate the communication of information between Vessel Operations Management, the Captain/Pilot of the vessel, the Maintenance department representatives, Schedulers, other Sales Department representatives, Customer Dock representatives and third-party providers for services such as shore tankering and spot horsepower. Record events and prepare...
-
Student Success Advocate I- College of Medicine
2 weeks ago
Houston, United States Houston Journal of Health Law & Policy Full timeDescription Summary Provides integrated career counseling, academic advising and educational counseling for undeclared and other targeted Medical Students served by our Student Affairs, Admissions, & Outreach department. Develop strategic plans to enhance student learning and empower students to successfully meet degree requirements and persist to...
-
Student Success Advocate I- College of Medicine
2 weeks ago
Houston, United States Houston Journal of Health Law & Policy Full timeDescriptionSummary Provides integrated career counseling, academic advising and educational counseling for undeclared and other targeted Medical Students served by our Student Affairs, Admissions, & Outreach department. Develop strategic plans to enhance student learning and empower students to successfully meet degree requirements and persist to graduation....
-
Student Success Advocate I- College of Medicine
2 weeks ago
Houston, United States Houston Journal of Health Law & Policy Full timeDescription Summary Provides integrated career counseling, academic advising and educational counseling for undeclared and other targeted Medical Students served by our Student Affairs, Admissions, & Outreach department. Develop strategic plans to enhance student learning and empower students to successfully meet degree requirements and persist to...