Member Care Coordinator

4 weeks ago

Springfield, United States Integrated Resources Full time

Job Title: Member Care Coordinator

Job Location: Remote + Field Visits in Springfield IL.

Job Duration: 6 months with possible extension.

Shift: 8:00 AM to 5:00 PM Monday – Friday.

Job Description

· Responsible for home health assessments and system updates.

· Perform outreach and follow up attempts to members on their health care plan.

· Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise.

· Inform and educate members on their program, may use supplied scripts.

· Complete records in system by performing data entry.

· Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation).

· Generate appropriate correspondence and send to member manually, electronically, or telephonically.

· Conduct check-ins with members to review individual care plan goals.

· Maintain production requirements based on established department business needs.

· Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate, manage, and close a case within the platform.

· Receive, analyze, conduct research and respond to telephone and/or written inquiries.

· Process information from member or provider to determine needs/wants and ensure customer questions have been addressed.

· Respond to customer or send to appropriate internal party.

· Notify help desk of system issues.

· Perform data entry function to update customer or provider information.

· Obtain required or missing information via correspondence or telephone.

· May serve as contact for the various groups regarding claims which involves conducting research, obtaining medical records/letters of medical necessity from TMG, reopen or initiate new cases as needed and refer case to clinicians.

· Support and maintain communications with various in-house areas regarding groups? concerns, i.e.: Marketing, Provider Affairs, and SSD.

· Communicate and interact effectively and professionally with co-workers, management, customers, etc.

· Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.

· Maintain complete confidentiality of company business.

· Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

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