Healthcare Enablement Specialist

7 days ago


SaintAubinsurGaillon, Normandie, United States Brighton Health Plan Solutions Full time

**About Us**

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, to solve the problems facing today's healthcare. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform.

We are seeking a skilled Senior Care Coordinator to join our team. As a Senior Care Coordinator, you will facilitate care management and utilization review by performing data collection, data entry, and effectively communicating with Nurse reviewers and leaders' employers and claimants in regard to their requests for preservice, prospective, and concurrent reviews.

The estimated salary for this position is $65,000 - $80,000 per year, depending on experience and qualifications.

Key Responsibilities:

  • Partner with leadership in cross training team members in all non-clinical departmental functions.
  • Create cases within the clinical platform while adhering to policies, procedure, and defined workflows.
  • Support Clinical staff as needed with administrative needs including but not limited to: outbound fax requests, telephonic communications, and reporting compilation.
  • Data entry of required clinical documentation as received via fax or portal submissions.
  • Telephonic interactions with physicians and/or representatives to acquire information or relay medical determination updates.
  • Perform Ad-Hoc projects and support departmental initiatives as needed.

Qualifications:

  • Strong PC skills (Excel is a must).
  • Excellent organizational skills including written and oral communication skills.
  • Ability to work independently and as a team player.
  • Minimum of one years' experience.
  • Bilingual preferred, but not required.
  • History working in medical records review, an MA or ancillary staff member preferred.


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