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Healthcare Systems Coordinator

4 weeks ago

Chicago, Illinois, United States PSG Global Solutions Careers Full time
Job Title: Member Care Coordinator

We are seeking a highly skilled Member Care Coordinator to join our team at PSG Global Solutions Careers. As a Member Care Coordinator, you will play a critical role in ensuring the well-being of our members by providing exceptional care and support.

Key Responsibilities:
  • Manage home health assessments and system updates to ensure accurate and timely information.
  • Perform outreach and follow-up attempts to members to educate them on their health care plan and encourage compliance.
  • Build relationships with members to understand their needs and provide personalized support.
  • Inform and educate members on their program, using supplied scripts to ensure consistency and accuracy.
  • Complete records in our system by performing data entry to ensure accurate and up-to-date information.
  • Encourage member usage of our programs, including arranging appointments and additional member services.
  • Generate appropriate correspondence and send to members manually, electronically, or telephonically.
  • Conduct check-ins with members to review individual care plan goals and provide support as needed.
  • Maintain production requirements based on established department business needs.
  • Provide support to the clinical team by performing non-clinical functions necessary to generate, manage, and close cases within our platform.
  • Receive, analyze, conduct research, and respond to telephone and/or written inquiries from members and providers.
  • Process information from members or providers to determine needs and ensure customer questions have been addressed.
  • Respond to customer inquiries or send to appropriate internal parties.
  • Notify the help desk of system issues to ensure prompt resolution.
  • Perform data entry functions to update customer or provider information.
  • Obtain required or missing information via correspondence or telephone.
  • May serve as a contact for various groups regarding claims, conducting research, obtaining medical records/letters of medical necessity, and referring cases to clinicians as needed.
  • Support and maintain communications with in-house areas regarding group concerns, including Marketing, Provider Affairs, and SSD.
  • Communicate and interact effectively and professionally with coworkers, management, customers, and other stakeholders.
  • 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.
Requirements:
  • Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.
  • Knowledge of medical terminology.
  • Experience coordinating member medical-related needs, providing assistance to members, and analyzing member needs.
  • PC proficiency, including Microsoft Office applications.
  • Customer service skills.
  • Verbal and written communications skills, including developing written correspondence to members and to other department personnel, and coaching skills, including motivational interviewing, to educate members on medical issues.
  • Current state driver's license, transportation, and applicable insurance.
  • Ability and willingness to travel.
About PSG Global Solutions Careers:

We are a fast-growing industry-recognized staffing firm recruiting critical IT, Financial, Engineering, Healthcare, and Data Analytics talent. With 20+ years' experience and growth, we connect top talent with premier organizations. Our company culture is built on relationships based on mutual interest, resulting in low turnover, long-lasting partnerships, and growth. If you're looking for a company invested in your success, join our team today