Care Management

Immediate need for a talented Care Management. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested.
 
Job ID:25-71237
 
Pay Range: $22 - $24/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:

• Works hard to collaborate with our internal medical director and clinical nursing to get peer to peer schedules to get authorizations approved for member svcs being requested.
• 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.
• (TBD)
• Needed for high call volume to fulfil service levels.
• Possibly, later in the year by September (TBD).
• In a live call que while navigating multiple systems scheduling peer to peer requests for our internal medical providers.
• All communications levels (Teams chats, emails, etc).
• Fast paced w/ high call volume; fluent process with how to get requests completed, cooperative, collaborative with leaders highly involved with processes.
• Assisting providers and members getting authorizations overturned.
• Works hard to collaborate with our internal medical director and clinical nursing to get peer to peer schedules to get authorizations approved for member svcs being requested.
• In comparison to other teams/LOBS/markets we are very competitive.
• Would gain self-confidence in overall communication w/ internal team and members, how to navigate through systems, as well as gaining experience with quickly adapting to change with the processes.

Key Requirements and Technology Experience:

• Key Skills:Trucare experience, , Medical Insurance, Member outreach, Calling, Call center experience,
• High school diploma or GED.
• Call center experience, Medical Insurance experience, Customer service, Problem solving skills.
• Trucare experience and phone system experience
• Disqualifiers: Not having a quiet place to take live calls and poor internet quality/speed.
• Performance indicators: Average handle time, Average hold time
• Best vs. average: Average Handle time of : 7 minutes vs 7.5 minutes
• Average hold time: 1 minutes vs 1.5 minutes.
• Customer Service
• Medical Insurance.
• Communication skills.
• Must have great organizational skills and easily coachable.

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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