Care Management Specialist

About the Client

The organization operates within the healthcare industry, focusing on improving health experiences for individuals through connected and compassionate care. It addresses challenges related to healthcare accessibility and coordination, aiming to simplify healthcare management for individuals, families, and communities.

About the Opportunity

The CARE MANAGEMENT SPECIALIST plays a vital role in coordinating care for members, particularly those with social determinants of health needs and stable health conditions. This position supports maintaining optimal health through member engagement, care plan development, and collaboration with an interdisciplinary team to address care barriers and health maintenance.

Responsibilities

• Engage telephonically with members for 50-75% of the workday.
• Reach out to and engage hard-to-reach members using all available resources.
• Develop individualized care plans with members to meet identified needs.
• Document care management activities accurately in electronic health records.
• Collaborate with interdisciplinary care team members to overcome barriers to care.
• Connect members with health plan benefits and community resources.
• Ensure compliance with regulatory requirements within required timelines.
• Consult and collaborate with Care Manager Registered Nurses for clinical guidance.
• Support team objectives, improve operational efficiency, and participate in special projects or mentoring as needed.

Requirements

• Minimum 2 years experience in a health-related field.
• Minimum 2 years customer service experience.
• Proficient with Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams).
• Access to a private, dedicated workspace and appropriate care arrangements for dependents during work hours.
• Associate’s Degree and relevant healthcare experience required; Practical Nurse Degree/Certificate with licensure or Bachelor’s Degree in healthcare or related field preferred.

Pay Range and Compensation Package

The typical pay range for this role is $21.10 to $40.90 per hour. This position is eligible for bonus, commission, or short-term incentive programs in addition to base pay.

Benefits & Perks

• Medical insurance
• Vision insurance
• Dental insurance
• 401(k) retirement plan