Manager, Svcs Coord Advocate

3 weeks ago

Houston, Texas, United States Harris Health System Full time

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.

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