Care Management Support Coordinator II

Immediate need for a talented Care Management Support Coordinator II. This is a 12+ Months Contract opportunity with long-term potential and is located in TX (Preferably located in McAllen, Edinburg, Donna, Weslaco, Mission, Pharr, San Juan, Alamo) (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-77262

Pay Range: $18 - $19/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:

• 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.
• Follow up on all pending services within 28 day follow up  
• Task new requests to social worker for MN determination.
• Set up/follow up member MD appointments
• Set up transportation.
• Provider searches
• UTL call member back
• Complete UTL process.
• Outreaches
• Disaster calls/ provider termination/ provider closures
• Internal follow up
• EVV, ERS notification
• Mail outs.
• Inventory, order Collateral supplies/resources.
• Interacting with the team lead and mentor.
• Task log to be submitted weekly with details to team lead. 

Key Requirements and Technology Experience:

• Skills-Excellent computer skills, Medical background as working in MD office, hospital, home health and Knowledge with Medical Terminologies.
• Bilingual ( no additional pay)
• Medical assistant experience.
• Metrics are measured during a call by the length of call, answering speed time, and professionalism.
• Ensure timely follow-up on all pending services within 28-day follow-up.  
• Once training is completed 15-20 members weekly.
• High School Diploma or GED.

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.
 
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