Mindlance
BusinessOperations - Care Management Support Coordinator II
Mindlance, Philadelphia, Pennsylvania, United States, 19700
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 experienceProvides 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 Comments for Vendors: May be required to come onsight once a month for a meeting MUST be familiar with basic medical terminology
Centene Job Description 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? Delaware First Health Great team support when needed N/ 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. 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 pediatric members (0-20) who have missed well child visits, members who have open care gaps, and any additional requests to support our members and our business. dditional business need N/ Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description 8:00 AM TO 5:00 PM 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. Emails/chats/calls Great team camaraderie 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 Gain experience in supporting pediatric members in closing care gaps and ensuring access to care. Our department supports team culture, allowing for everyone to contribute their skills and knowledge to the department's success. N/ N/ N/
Candidate Requirements
Education/Certification
Required: High School diploma, or equivalent. 2-3 years managed care setting, medical office or facility setting w/ demonstration of medical administration duties. Preferred:
Licensure
N/ Preferred:
Years of experience required Disqualifiers Best vs. average Performance indicators Must haves: 2-3 years in managed care setting, medical office, or equivalent. Member or patient facing experience. Experience with high call volume; 50+ inbound/outbound calls/daily.
Nice to haves: Knowledge of medical terminology. Experience with Microsoft office including Excel and Word.
Disqualifiers: No experience in healthcare setting, medical setting, or managed care setting.
Performance indicators: Ability to meet performance metrics and expectations of role.
Best vs. average: N/
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection 1 Patient Assessment 2 Communication 3 Computer Literacy
Candidate Review & Selection
Shortlisting process Second touchpoint for feedback Interview Information Onboard Process and Expectations Projected HM Candidate Review Date: N/ Number and Type of Interviews: Microsoft Teams, Extra Interview Prep for Candidate: N/ Required Testing or Assessment (by Vendor): N/
Manager Communication Preferences & Next Steps
Background Check Requirements (List DFPS or other specialty checks here) N/
Do you have any upcoming PTO? N/
Colleagues to cc/delegate N/ EOD: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."
Education/Experience: Requires a High School diploma or GED Requires 1 - 2 years of related experienceProvides 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 Comments for Vendors: May be required to come onsight once a month for a meeting MUST be familiar with basic medical terminology
Centene Job Description 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? Delaware First Health Great team support when needed N/ 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. 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 pediatric members (0-20) who have missed well child visits, members who have open care gaps, and any additional requests to support our members and our business. dditional business need N/ Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description 8:00 AM TO 5:00 PM 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. Emails/chats/calls Great team camaraderie 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 Gain experience in supporting pediatric members in closing care gaps and ensuring access to care. Our department supports team culture, allowing for everyone to contribute their skills and knowledge to the department's success. N/ N/ N/
Candidate Requirements
Education/Certification
Required: High School diploma, or equivalent. 2-3 years managed care setting, medical office or facility setting w/ demonstration of medical administration duties. Preferred:
Licensure
N/ Preferred:
Years of experience required Disqualifiers Best vs. average Performance indicators Must haves: 2-3 years in managed care setting, medical office, or equivalent. Member or patient facing experience. Experience with high call volume; 50+ inbound/outbound calls/daily.
Nice to haves: Knowledge of medical terminology. Experience with Microsoft office including Excel and Word.
Disqualifiers: No experience in healthcare setting, medical setting, or managed care setting.
Performance indicators: Ability to meet performance metrics and expectations of role.
Best vs. average: N/
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection 1 Patient Assessment 2 Communication 3 Computer Literacy
Candidate Review & Selection
Shortlisting process Second touchpoint for feedback Interview Information Onboard Process and Expectations Projected HM Candidate Review Date: N/ Number and Type of Interviews: Microsoft Teams, Extra Interview Prep for Candidate: N/ Required Testing or Assessment (by Vendor): N/
Manager Communication Preferences & Next Steps
Background Check Requirements (List DFPS or other specialty checks here) N/
Do you have any upcoming PTO? N/
Colleagues to cc/delegate N/ EOD: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."