Hybrid - Care Navigator - Medical Assistant - Case Manager Coordinator
3 weeks ago
Why This Role is Important to Us: Commonwealth Care Alliance’s (CCA) Care Navigation Specialist is primarily responsible for providing administrative support to the Care Team and CCA CA/MA/ MI members to ensure proper service provision, care coordination and member engagement. The Care Navigation specialist establishes rapport via telephonic interactions with members, caregivers, and providers in order to effectively meet the member’s care coordination needs and support satisfaction with CCA services. What You'll Be Doing: Answer incoming member calls for non-clinical issues and questions with the goal of first call resolution with each interaction Initiate outreach to members, vendors, providers, and/or suppliers to follow-up on non-clinical matters assigned by the Care Partner (e.g., including authorization status, DME status, and prescription assistance) MA/MI only : Assist members with DME and supply questions, coordinate with DME and Supply Procurement Unit (DSPU) and any other relevant department(s) Assist members with authorization questions, coordinate with relevant department(s) within CCA, or contracted IPAs Assist members with appeals and grievances status, coordinate with Appeals and Grievances department (A&G) and any other relevant department(s) Assist members with scheduling post-assessment PCP or specialty appointments; follow-up to ensure members attended appointments Educate members about their benefits and how to access them, coordinating with the Contact Center/Member Services team Help members schedule transportation to medical and social appointments. Maintain proper documentation in member's chart. Support engagement and member education activities through outbound call and mail campaigns Attend morning huddles and team meetings (as required)Additional duties as requested by supervisor Working Conditions: Standard office conditions. Eligible to hybrid remote work, with time spent in community, member-facing Must be able to come to the local CCA office in the event CCA phone system is unavailable from remote work location Must have strong internet signal at remote work location Must be able to come to the local CCA office for administrative activities and scheduled meetings on a regular basis May require meetings across the state of (MA / CA / MI ) What We're Looking For: Qualifications: Associate degree or a minimum of 2+ years of applicable experience,Bachelor's degree preferred. 2+ years office/administration required,Experience working in a health plan, medical group, health-related facility or medical/DME supplier a plus Knowledge, Skills & Abilities Required: Excellent critical thinking and troubleshooting skills Strong customer service and problem-solving skills Ability to work in multiple systems, often simultaneously Clear, concise, and effective oral and written communication Strong time management and demonstrated ability to work independently Flexibility to adapt to business needs Motivated team player Excellent organizational skills High attention to detail and accuracy Basic arithmetic skills required Proficiency in Microsoft Office Suite Knowledge, Skills & Abilities Desired: Knowledge of medical terminology Language(s): English required,Spanish/Vietnamese preferred EEO is The Law Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
-
Worcester, United States Commonwealth Care Alliance Full timeWhy This Role is Important to UsCommonwealth Care Alliance's (CCA) Care Navigation Specialist is primarily responsible for providing administrative support to the Care Team and CCA CA/MA/ MI members to ensure proper service provision, care coordination and member engagement. The Care Navigation specialist establishes rapport via telephonic interactions with...
-
Hybrid Care Navigator
3 weeks ago
Worcester, United States Commonwealth Care Alliance Full timeJob Summary: Commonwealth Care Alliance’s (CCA) Care Navigation Specialist is primarily responsible for providing administrative support to the Care Team and CCA CA/MA/ MI members to ensure proper service provision, care coordination and member engagement. The Care Navigation specialist establishes rapport via telephonic interactions with members,...
-
Behavioral Health Case Manager
6 days ago
Worcester, United States Fallon Health Full timeOverview: About Fallon Health: Fallon Health is a mission-driven not-for-profit health care services organization based in Worcester, Massachusetts. For 45 years we have been improving health and inspiring hope in the communities we serve. Committed to caring for those who need us most, we pride ourselves on providing equitable access to coordinated,...
-
Spanish Speaking Care Coordinator/ Navigator
1 month ago
Worcester, United States Fallon Health Full timeOverview: About us: Fallon Health is a company that cares. We prioritize our membersalwaysmaking sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nations top health plans for member experience, service, and clinical quality....
-
Spanish Speaking Care Coordinator/ Navigator
4 weeks ago
Worcester, United States Fallon Health Full timeOverview: About us: Fallon Health is a company that cares. We prioritize our membersalwaysmaking sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nations top health plans for member experience, service, and clinical quality....
-
Bilingual Case Manager
2 weeks ago
Worcester, United States Organization for Refugee and Immigrant Success Full time**About ORIS**:The Organization for Refugee and Immigrant Success (ORIS) is an ethnic community-based nonprofit organization with the mission to aid in the resettlement of refugees and immigrants in Massachusetts and New Hampshire by providing training, assistance, resources, and opportunities that promote self-sufficiency. ORIS’s Board of Directors and...
-
Recovery Support Navigator
4 weeks ago
Worcester, United States Spectrum Health Systems Full timeRecovery Support Navigator Worcester, MA, USA Req #3609 Tuesday, May 21, 2024 Location: Worcester, MA - Lincoln Street Outpatient Treatment Program Pay rate: $20.90/ hour Schedule: Monday and Thursday 9:00am-5:30pm, Tuesday, Wednesday, and Friday 7:00am-3:30pm Benefits: 401k with company contribution Health, dental, vision...
-
Recovery Support Navigator
4 weeks ago
Worcester, United States Spectrum Health Systems Full timeRecovery Support Navigator Worcester, MA, USA Req #3609 Tuesday, May 21, 2024 Location: Worcester, MA - Lincoln Street Outpatient Treatment Program Pay rate: $20.90/ hour Schedule: Monday and Thursday 9:00am-5:30pm, Tuesday, Wednesday, and Friday 7:00am-3:30pm Benefits: 401k with company contribution Health, dental, vision...
-
Recovery Support Navigator
1 month ago
Worcester, United States Spectrum Health Systems Full timeRecovery Support NavigatorWorcester, MA, USA Req #3609Tuesday, May 21, 2024Location: Worcester, MA - Lincoln Street Outpatient Treatment Program Pay rate: $20.90/ hour Schedule: Monday and Thursday 9:00am-5:30pm, Tuesday, Wednesday, and Friday 7:00am-3:30pm Benefits: 401k with company contribution Health, dental, vision insurance Paid time off Tuition...
-
Recovery Support Navigator
4 weeks ago
Worcester, United States Spectrum Health Systems Full timeRecovery Support NavigatorWorcester, MA, USA Req #3609Tuesday, May 21, 2024Location: Worcester, MA - Lincoln Street Outpatient Treatment Program Pay rate: $20.90/ hour Schedule: Monday and Thursday 9:00am-5:30pm, Tuesday, Wednesday, and Friday 7:00am-3:30pm Benefits: 401k with company contribution Health, dental, vision insurance Paid time off Tuition...
-
Medical Recovery Support Navigator
1 week ago
Worcester, United States Spectrum Health Systems Full timeMedical Recovery Support Navigator Worcester, MA, USA Req #3637 Friday, June 21, 2024 Location: Worcester, MA. Pleasant Street Outpatient. Pay Rate: $20.90/hour Schedule: Monday to Friday: Mon 8:00 am -5:00 pm, Tues 7:30 an- 4:00 pm, Wed 8:00 am-6:00 pm, Thu 7:30 am- 4:00 pm, Fri 8:00 am- 2:00pm Benefits: 401k with company...
-
Community Supports Navigator
1 month ago
Worcester, United States Ascentria Care Alliance Full timeThe Community Supports Navigator is expected to build and then maintain positive, healthy relationships with individuals, families, collaterals and all other stakeholders. The Navigator will respond to identified needs via a wide range of available services/supports. This position will assist in the navigation of public benefits, entitlements and systems...
-
Community Supports Navigator
4 weeks ago
Worcester, United States Ascentria Care Alliance Full timeThe Community Supports Navigator is expected to build and then maintain positive, healthy relationships with individuals, families, collaterals and all other stakeholders. The Navigator will respond to identified needs via a wide range of available services/supports. This position will assist in the navigation of public benefits, entitlements and systems...
-
Medical Recovery Support Navigator
1 week ago
Worcester, United States Spectrum Health Systems Full timeMedical Recovery Support NavigatorWorcester, MA, USA Req #3637Friday, June 21, 2024Location: Worcester, MA. Pleasant Street Outpatient. Pay Rate: $20.90/hour Schedule: Monday to Friday: Mon 8:00 am -5:00 pm, Tues 7:30 an- 4:00 pm, Wed 8:00 am-6:00 pm, Thu 7:30 am- 4:00 pm, Fri 8:00 am- 2:00pm Benefits: 401k with company contribution Health, dental, and...
-
Case Manager
1 week ago
Worcester, United States Promises Behavioral Health, LLC Full time**Position Summary** The Case Manager plans, implements, and coordinates an array of comprehensive, individualized client services during their residency and in preparation for continuing care and safe, sober housing after discharge. The Case Manager also delivers psychoeducational and motivational enhancement instruction in group and individual settings...
-
Insurance Navigation Manager
2 months ago
Worcester, United States University of Massachusetts Full timeOverview POSITION SUMMARY: Under the general direction of the Center Director or designee, the Insurance Navigation Manager provides information, resources, and technical assistance to consumers, providers, educators, employers, and others around issues related to insurance coverage for autism and behavioral health. The Insurance Navigation...
-
Recovery Support Navigator
1 month ago
Worcester, United States Spectrum Full timeLocation: Worcester, MA – Lincoln Street Outpatient Treatment Program Pay rate: $20.90/ hour Schedule: Monday and Thursday 9:00am-5:30pm, Tuesday, Wednesday, and Friday 7:00am-3:30pm Benefits: 401k with company contribution Health, dental, vision insurance Paid time off Tuition reimbursement Discounts on wide array of services/entertainment ...
-
Recovery Support Navigator
4 weeks ago
Worcester, United States Spectrum Full timeLocation: Worcester, MA – Lincoln Street Outpatient Treatment Program Pay rate: $20.90/ hour Schedule: Monday and Thursday 9:00am-5:30pm, Tuesday, Wednesday, and Friday 7:00am-3:30pm Benefits: 401k with company contribution Health, dental, vision insurance Paid time off Tuition reimbursement Discounts on wide array of services/entertainment ...
-
Case Manager
2 weeks ago
Worcester, Massachusetts, United States Promises Behavioral Health, LLC Full timePosition Summary The Case Manager plans, implements, and coordinates an array of comprehensive, individualized client services during their residency and in preparation for continuing care and safe, sober housing after discharge. The Case Manager also delivers psychoeducational and motivational enhancement instruction in group and individual settings and...
-
Case Manager
1 month ago
Worcester, United States Promises Behavioral Health, LLC Full timePosition Summary The Case Manager plans, implements, and coordinates an array of comprehensive, individualized client services during their residency and in preparation for continuing care and safe, sober housing after discharge. The Case Manager also delivers psychoeducational and motivational enhancement instruction in group and individual settings and...
