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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.
Describe the performance expectations/metrics for this individual and their team:
• Production based role-quantity of calls, how many members agree to sign up
*Additional Skills & Qualifications:*
Internal/External Groups with which the Candidate will interface:
Required Skills/Experience:
1-2 years’ experience in fast paced call center
At least 2 years of prior Healthcare experience
Ability to adapt to change
Software Skills Required: Excel, MS office
Preferred Skills/ Experience:
1. SALES highly preferred
2. Bilingual in Spanish a plus
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
