Care Support Specialist

4 weeks ago


San Diego, California, United States Magellan Health Full time
Care Support Role Overview

This is a remote position in California, where candidates must reside in the state. The Care Support Specialist will provide administrative and logistics support to Clinical Operations Care Managers in the execution of care planning and coordination of care and services associated with person-centered care plans for the Medicaid, Medicare, and Whole Health markets. This is an unlicensed member of the care team. The Specialist will enable community research and education for members in care management, along with supporting member engagement with their primary care and other sources of support. They will work with licensed Care Managers to meet standards of care and performance set by the Member Market Leads and Care Management Center of Operational Excellence Lead.

Key Responsibilities

Provides non-clinical support within the model of care by providing administrative and logistics support for membership.

Performs administrative tasks to support the implementation of care plans, including outreach to providers and community resources to connect members and to perform appropriate follow-up.

Provides information to members and providers regarding company policies and procedures, mental health managed care programs and community treatment resources.

Assists in coordinating behavioral health services for members and supports efforts to link members to appropriate services.

Effectively communicates with appropriate care team members or Care Manager when an appropriate provider, type of service or appropriate level of care cannot be readily found.

Assists with transition of care activities for members in treatment and support communication with members, hospitals and providers (e.g., discharge planning, member appointment reminder calls, post discharge calls, medication checks, appointment verification calls).

Works collaboratively with all clinical operations team members including other care support resources, care managers, transition of care teams, outreach and engagement teams, etc. to enable effective and efficient support of member care.

Requirements

Ability to plan and implement solutions that directly influence quality of care.

Understanding of health plan benefit structures, psychiatric/medical terminology, call center terminology and operations.

Ability to successfully engage, motivate, and communicate with members, team supports, and critical stakeholders.

Strong interpersonal skills.

Strong written and verbal communication skills.

Magellan Health

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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