Description

GENERAL DEFINITION OF WORK:

Oversees the daily operations of the managed care program. Assists the director with implementation of strategies to provide the best possible healthcare-specific customer service and support to clients. Supervises the Community Health Coordinators. Reports directly to the Director of Business Development.

TYPICAL TASKS

• Responsible for participating in the recruitment, onboarding, and training process for MCO staff 
• Supervises, coaches and trains MCO staff
• Reviews employee payroll time sheets for accuracy of hours, accounts charged, and submits to payroll within established timeframes.
• Analyzes and plans MCO operations and implements improvements as needed. 
• Directly responsible in ensuring that services and programs meet mandated guidelines and requirements
• Provides input to Director for staffing and operational budget and monitors budget throughout the fiscal year.
• Responsible for staying abreast on all program updates and changes
• Attends all meetings with program partners
• Prepares reports and documents as required by Director, Agency and by local, state, and federal authorities. 
• Perform all aspects and requirements related to professional correspondence and data entry for coordinated care activities: 
•  Use telephone system to connect to the appropriate clients 
• Use proper customer service skills and professionalism at all times
• ·Handle requests for information and data 
• Complete member health assessments and health screenings
• Document member information in an internet-based portal in accordance with health plan requirements
• Make referrals to community resources to improve health outcomes
• Follow up with members/participants
• Enter data into computer system; establish entry priorities 
• Ability to work independently with little supervision to meet weekly and monthly goals
• Report on work completed on a routine basis to establish productivity standards
• Collaborates with other agencies, health care providers, and community resources to facilitate any additional referrals needed, as well as to build and maintain professional relationships
• Educates the public through meetings and professional presentations
• Performs additional tasks as required.

Requirements

KNOWLEDGE, SKILLS AND ABILITIES 

• Working knowledge of Microsoft Office programs (Word, Excel, Outlook, PowerPoint) and standard office equipment 
• Data entry and evaluation 
• Strong customer service and interpersonal skills to establish and maintain trusting professional relationships. 
• Excellent verbal communication skills, both face-to-face and telephonically
• Excellent written communication skills (letters, memos, reports, emails)
• Understanding of client confidentiality and HIPPA privacy rules
• Recording client data and accurately entering information into computer systems in a timely manner 
• Previous experience working in an office setting and using computerized multi-line call systems 
•  Ability to work remotely. This position has the flexibility to work a set hybrid schedule with both in office and remote hours, after training is completed

EDUCATION AND EXPERIENCE

• Associate’s degree in business, management, or closely related field from an accredited college or university (preferred)
• Three (3) years’ work experience in leadership and sales preferred
• Experience in healthcare or healthcare customer service required.
•  Excellent customer service and verbal telephonic skills. 
• Must possess a valid and current Commonwealth of Virginia Driver’s license, have, and maintain a minimum 2 driving record.