Mindlance
BusinessOperations - Care Management Support Coordinator II
Mindlance, United, Pennsylvania, us, 15689
Position Purpose:
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.
Education/Experience: Requires a High School diploma or GED Requires 1 - 2 years of related experience
License/Certification:
For Florida-Sunshine Health Plan - All interactions with members are done telephonically
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
EEO:
"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."
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Story Behind the Need - Business Group & Key Projects Health plan or business unit Team culture Surrounding team & key projects Purpose of this team Reason for the request Motivators for this need ny additional upcoming hiring needs? Requesting as a business need to add support to the team who serve our member population. Contract requirements are in place to ensure we are meeting the needs of our members. Our team outreaches every new member of Delaware First Health, 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.
This is a replacement request for contractors, Monique Cornish and Christopher Ferrell
Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description 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.
Compelling Story & Candidate Value Proposition
What makes this role interesting? Points about team culture Competitive market comparison Unique selling points Value added or experience gained Our department supports team culture, allowing for everyone to contribute their skills and knowledge to the department's success.
Education/Experience: Requires a High School diploma or GED Requires 1 - 2 years of related experience
License/Certification:
For Florida-Sunshine Health Plan - All interactions with members are done telephonically
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
EEO:
"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."
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Story Behind the Need - Business Group & Key Projects Health plan or business unit Team culture Surrounding team & key projects Purpose of this team Reason for the request Motivators for this need ny additional upcoming hiring needs? Requesting as a business need to add support to the team who serve our member population. Contract requirements are in place to ensure we are meeting the needs of our members. Our team outreaches every new member of Delaware First Health, 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.
This is a replacement request for contractors, Monique Cornish and Christopher Ferrell
Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description 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.
Compelling Story & Candidate Value Proposition
What makes this role interesting? Points about team culture Competitive market comparison Unique selling points Value added or experience gained Our department supports team culture, allowing for everyone to contribute their skills and knowledge to the department's success.