Care coordinator (DME/Star Plus)

Immediate need for a talented Care coordinator (DME/Star Plus). This is a 12+ Months Contract opportunity with long-term potential and is located in Texas (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-67381

Pay Range: $16.50 - $17/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:

• Shift (Start/End Time): Monday- Friday 8am to 5pm CT. Currently working 5-10 hours of overtime weekly. Subject to change based on business needs.
• "Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed.
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member’s care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community-based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned
• Complies with all policies and standards".
• Focus on coordinating durable medical equipment (DME), medical supplies, and adaptive aids for the STAR PLUS Waiver population.
• Coordination of service requests will consist of educating members regarding DME benefits and DME requirements.
• Helping members schedule primary care physician (PCP) appointments.
• Identifying a DME agency that can provide items needed.
• Coordinate with DME agencies, PCPs and members to ensure DME orders are obtained, and all requirements are met for an authorization.
• Advocate for members to ensure members receive needed DME item(s).
• Follow-up with member to confirm delivery and satisfaction with DME item.

Key Requirements and Technology Experience:

• Skills-Durable Medical Equipment (DME), Member services & managed care.
• 1 year of experience in the following settings: customer service, managed care and/or healthcare setting.
• Experience working with DME or healthcare setting. Experience working remotely.
• Performance based on number of member request addressed daily and quality of work.
• Performance and quality metrics will be discussed during new hire training.
• 1 year of experience; thorough knowledge of customer service, experience in a managed care environment or healthcare field.
• Experience operating office equipment/computer.
• Knowledge of medical terminology.

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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