What are the responsibilities and job description for the Care Management Support Coordinator position at Pyramid Consulting, Inc?
Job ID: 25-63443
Pay Range: $21 - $22/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: 8:00 AM - 5:00 PM EST, possibility of overtime according to business needs
- 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 following current state and regulatory guidelines.
- Outreach to complex or high-risk members, members who have called into Member Services requesting additional assistance, members who have open care gaps, and any additional requests to support our members and our business.
- Daily outreach calls to members, providers, and pharmacies. Assistance with appointment linkage, community resource connections, social determinants of health needs.
- Identify members without a PCP and assist with obtaining one. Screen members for eligibility to enroll in Care Coordination services. Enter assessments and notes into charting system.
- 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 plans 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 followed, and provides to providers as needed.
- Knowledge of existing benefits and resources locally, and make referrals to address the Social Determinants of Health (SDOH) needs
- 40 calls per day reaching out to the members assigned. Metrics must be met weekly to meet the expectations that are set by the department.
- Training through online modules, 4 to 6 weeks of training, and training with the hiring manager and department for the role they are hired to do as a program coordinator.
Key Requirements and Technology Experience:
- Key skills; Patient Assessment
- Communication
- Computer Literacy
- 2 years of RECENT EXPERIENCE - Member/Patient Assessment in Health Insurance/Managed Care/Medical Office setting w/ demonstration of medical administration duties
- Knowledge of medical terminology, ability to meet performance metrics/expectations, ability to be punctual and reliable on the job with good job tenure.
- Professional Spoken Communication Skills, Typing Skills (40 WPM), Computer Skills: Proficient with Microsoft Office (Word, Excel, Outlook), and multitasking using multiple systems and programs simultaneously. A reliable home internet is required (a hard-wired internet connection) with a dedicated workspace due to HIPAA.
- Proof of High School Diploma/GED or higher is REQUIRED. Must have an on-hand copy of HSD/GED/Transcript.
- Attendance/Reliability needed. Attendance is mandatory - no time off allowed during training
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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Salary : $21 - $22
