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Healthcare Support Services Representative

2 months ago

Corpus Christi, Texas, United States Centene Corporation Full time
Job Summary

We are seeking a highly skilled Care Management Support Coordinator to join our team at Centene Corporation. As a key member of our care management team, you will play a critical role in supporting our members and providers with administrative care management activities.

Key Responsibilities
  • Provide outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling, and ongoing education for both the member and provider throughout care/service
  • Provide experienced support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
  • May apply in-depth knowledge of assigned health plan(s) activities and resources
  • Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures and protocols
  • Applies in-depth knowledge of care management support activities including care plans and community resources
  • Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
  • Works with care management team on escalating requests and inquiries to management
  • Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
  • May support training of new hires
  • Performs other duties as assigned
  • Complies with all policies and standards
Requirements
  • Requires a High School diploma or GED
  • Requires 2 - 4 years of related experience
  • Preferred Work Experience: 4+ years of experience with internal auditing, data mining, creating job aides and reports, and collaborating with regulatory compliance stakeholders for government sponsored programs (i.e. STAR Health, STAR Plus, STAR Kids,)
  • Business Analysis Knowledge: 2+ years of experience engaging and partnering with Program Support Units, HHSC, and Service Coordination providers and clinical staff to conduct regulatory audits and data analysis
  • Must have strong analytical and problem-solving skills
  • Role requires strong attention to detail, organizational and time management skills
  • Proficient Computer Skills and Search Navigation: Moderate proficiency in Excel skills (i.e. using Filters, V look-ups, Pivot Tables, Sorting data, etc.) is required - 90% of role duties and responsibilities is working in Excel
  • Proficient computer skills, knowledge, and experience working within large databases or provider information systems
  • Microsoft Office applications (Excel, Outlook, Word) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing)
  • Comfortable using digital video conferencing platforms (Zoom, MS Teams)
  • Effective Customer Service: Skilled to communicate with all levels of management, internal and external customers
  • Role requires excellent customer service and emotional intelligence skills
  • Ability to collaborate with team members and work independently
  • Effective Business Communication: Skilled in communicating with technical and business constituencies
  • Must be highly adaptable/flexible to changes and skilled at learning new processes