Mindlance
BusinessOperations - Care Management Support Coordinator II
Mindlance, Texas City, Texas, us, 77592
Job Description: 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 Centene Job Description
"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" 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? The Specialty Authorization Team consists of the processing of authorizations and follow-ups for DME, MHM, DAHS, and reductions/denials in which we are now at a 1 Client TAT for the processing of SK/SH/MMP authorizations. We utilize project temps/contingent workers to assist with each of these areas as well as cross train them to be able to assist in multiple functions. The team continues to experience high authorization volumes.
Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description Daily check in & communication via group IM(s) Daily production logs must be completed and emailed to designated individual no later than 9am next business day Multi-tasking with multiple monitors and applications Utilize work guides and or resources 97% Quality (Audits) 98% Production 0-5% Error Rate 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 We work together like a family rather than co-workers in which helps facilitate the best care for those we serve by being committed, flexible, and compassionate to enhance the lives of each and every Member.
Candidate Requirements
Education/Certification
Required: High School/GED Preferred:
Licensure
Required: Preferred: LPN, LVN, or LCSW preferred.
Years of experience required Disqualifiers Best vs. average Performance indicators Must haves:
Nice to haves: Other state specific requirements may apply. Nice to haves: 2+ years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions. Other state specific requirements may apply. Preferred: LPN, LVN, or LCSW preferred
Disqualifiers:
Performance indicators:
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection 1 Microsoft Outlook, Microsoft Teams, Zoom, Microsoft Word, Microsoft Excel, SharePoint, Internet 2 2+ years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions. EEO: "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 Centene Job Description
"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" 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? The Specialty Authorization Team consists of the processing of authorizations and follow-ups for DME, MHM, DAHS, and reductions/denials in which we are now at a 1 Client TAT for the processing of SK/SH/MMP authorizations. We utilize project temps/contingent workers to assist with each of these areas as well as cross train them to be able to assist in multiple functions. The team continues to experience high authorization volumes.
Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description Daily check in & communication via group IM(s) Daily production logs must be completed and emailed to designated individual no later than 9am next business day Multi-tasking with multiple monitors and applications Utilize work guides and or resources 97% Quality (Audits) 98% Production 0-5% Error Rate 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 We work together like a family rather than co-workers in which helps facilitate the best care for those we serve by being committed, flexible, and compassionate to enhance the lives of each and every Member.
Candidate Requirements
Education/Certification
Required: High School/GED Preferred:
Licensure
Required: Preferred: LPN, LVN, or LCSW preferred.
Years of experience required Disqualifiers Best vs. average Performance indicators Must haves:
Nice to haves: Other state specific requirements may apply. Nice to haves: 2+ years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions. Other state specific requirements may apply. Preferred: LPN, LVN, or LCSW preferred
Disqualifiers:
Performance indicators:
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection 1 Microsoft Outlook, Microsoft Teams, Zoom, Microsoft Word, Microsoft Excel, SharePoint, Internet 2 2+ years of experience in a managed care environment or working with people who have disabilities and/or with vulnerable populations who have chronic or complex conditions. EEO: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."