Care Management Support Coordinator II - J01003
BC Forward is looking for Care Management Support Coordinator II (Remote) in AZ/TX
Position Title: Care Management Support Coordinator II (Remote)
Locations: Remote - AZ/TX
Anticipated Start Date: 08/26
Expected Duration: 6 Months
Job Type: Contract with possible extension
Shift: The shift schedule is Monday through Friday, from 11:30 AM to 8:00 PM EST (which corresponds to 8:30 AM to 5:00 PM MST). As we are primarily looking to cover the 11:30 AM - 8:00 PM EST time window, candidates based in Arizona or Texas are strongly preferred due to time zone alignment.
Pay Rate $24.75/hr on W2.
Need: 2-3 years in managed care, medical office, or call center with customer service experience (Medicare/Medicaid preferred), referral coordination, community resources navigation, English/Spanish bilingual (preferred), and strong typing skills.
Job Description:
Position Summary:
The Care Management Support Coordinator II plays a vital administrative and customer service role in supporting care management activities. This includes conducting outreach, handling inbound calls, scheduling services, and connecting members with care resources. The coordinator serves as a key liaison between members, providers, and internal teams to ensure efficient resolution of concerns and proper documentation in accordance with state and regulatory standards.
Key Responsibilities:
- Conduct telephonic outreach to members to assist with care plan next steps, appointment scheduling, and education about available resources.
- Respond to inbound calls from members and providers, resolving inquiries related to services, referrals, and benefits.
- Provide support during member onboarding including sending welcome letters, educational materials, and other essential documentation.
- Guide members in accessing internal and community-based services that address health, social, and environmental needs (Social Determinants of Health).
- Maintain non-clinical member records with accuracy, ensuring compliance with all relevant regulations and standards.
- Act as a frontline support representative to educate members and providers on care plan procedures and program expectations.
- Collaborate with internal departments to facilitate coordination of care and resolve service gaps.
- Refer individuals to local resources in areas such as food, housing, transportation, financial support, and health/medical services.
- Contribute to initiatives of the Community Connections Help Line (CCHL), which serves both WellCare members and the general public by connecting them with vital social service resources.
Example 1: A caller needing wheelchair-accessible transportation to visit a family member in a nursing home was referred to New Freedom Transportation. The referral allowed the member to maintain emotional and physical well-being by facilitating frequent visits.
Example 2: A member struggling to afford a $2,500 co-pay for vital medication was connected to Caring Voices Coalition, resulting in full financial assistance and reduced stress.
Performance Metrics:
- Inbound Call Handling Time (AHT): Target
- Outbound Call Handling Time (AHT): Target
- Quality Assurance Scores: > 90%
- Service Level Agreement (SLA): 80% of calls answered within 30 seconds (team goal)
- Wrap-Up Time: Should be limited if negatively impacting overall AHT
- Monthly Goals: Set by leadership and subject to change per departmental needs
- System access setup, IT orientation, and introduction to Centene University courses
- Review of job description, expectations, and departmental policies
- Overview of the Community Connections Help Line's mission and objectives
- Training with team leads and subject matter experts
- 2-3 years of experience in a managed care environment, medical office, or call center
- Prior customer service experience, especially with Medicare/Medicaid beneficiaries
- Experience providing referrals and navigating community-based services
- Familiarity with medical terminology and managed care procedures
- Knowledge of systems such as Citrix, Microsoft Office (Teams, Excel), and ability to multi-task effectively
- Proven ability to remain calm, empathetic, and solution-focused in fast-paced environments
- Solid tenure and dependability in past employment roles
- Bilingual in English and Spanish (highly preferred)
- Strong communication and interpersonal skills
- Typing proficiency (Typing speed test may apply)
- Problem-solving mindset with a compassionate approach
- Ability to handle sensitive situations and maintain confidentiality
Interested candidates please send resume in Word format Please reference job code 240925 when responding to this ad.