Care Management Support Coordinator II

Immediate need for a talented Care Management Support Coordinator II. This is a 06+months contract opportunity with long-term potential and is located in MO(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-85087

Pay Range: $22 - $23/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Hours: Full time - 40 hours per week 
• Schedule: Monday to Friday, 8:00 am to 5:00 pm CST / No OT, no holidays, no weekends expected
• Training: Remote / Monday to Friday, 8:00 am to 5:00 pm CST / 4 weeks course / NO TIME OFF / CAMERAS ON
• Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services.
• Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.
• Provides 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.
• Provides 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 working 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.
• 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.
• 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.
• Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs.
• Performs other duties as assigned.
• Complies with all policies and standards.
• We continue to outreach members that have HSH to provide Care coordination and support for these members of all populations.
• We have Adult, Pediatric, NICU, BH and OB Care Management and need support with outreaching to provide explanation of our program and benefits. 
• Will focus on outreach efforts to educate on benefits and CM program.
• Work off of a report if necessary to target a specific population to include completion of post discharge assessments, Health Risk Screenings, provide education on care gaps, and provide resources to members, including plan benefits and community resources.
• Care coordinators make outbound calls to guardians/members to complete HRS and benefit education.
• Our care management support team members outreach approximately 20 members per day to complete a health risk assessment with a 30% success rate.
• The position is 100% remote, but we have a Teams chat for support and to be able to answer questions amongst the team.

Key Requirements and Technology Experience: 

• Key skills; 2 years in medical office setting experience
• Strong communication skills, empathy towards members
• Excellent computer skills/tech savvy, attention to detail, independent work & with team, ability to multi-task
• Strong dependable Internet service, phone queue experience (insurance, case management OR clinical experience).
• Patient care experience (adult, Pediatric, NICU, BH and OB Care), WFH experience, managed care experience, CNA.
• There will be quality metrics- evaluated and audited for quality of documentation and calls.
• Additionally, an expectation of 20-25 calls/day.
• Review process evaluation according to success rate.
• Strong communication skills, empathy towards members
• Excellent computer skills / tech savvy / attention to detail / independent work & with team
• Ability to Multi-task (Excel, Trucare, Teams, Word, One note, Outlook)
• High School Diploma or equivalent

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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