Care Management Support Specialist II

2 weeks ago


Willowbrook, California, United States Accede Solutions Inc. Full time

Position Overview:
This role is integral in facilitating administrative care management functions, which include outreach initiatives, handling incoming calls, and coordinating service schedules.

Key Responsibilities:
- Act as a primary contact for members, healthcare providers, and internal staff to address and resolve inquiries, ensuring thorough documentation of member records in compliance with state and regulatory standards.
- Assist members in connecting with health plan resources and community services to guarantee high-quality customer service and care.
- Utilize knowledge of assigned health plans to support various member and provider inquiries, clarifying care plan procedures and protocols.
- Oversee member onboarding processes and daily administrative tasks, including dispatching welcome letters and educational materials to foster effective member/provider relationships.
- Maintain and document non-clinical member records to align with best practices and regulatory requirements, providing necessary information to providers as needed.
- Stay informed about local benefits and resources, making referrals to address Social Determinants of Health (SDOH) needs.
- Perform additional duties as assigned, adhering to all policies and standards.

Qualifications:
- High School diploma or GED is required.
- A minimum of 2 years of relevant experience is necessary.

In this role, you will engage with members via phone to guide them through care plan steps, community resources, and any scheduling or educational inquiries related to their care.



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