Care Management Support Coordinator II - LTSS Medicaid Services

About the role

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.

Responsibilities

• 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

Requirements

• High School diploma or GED
• 1 – 2 years of related experience

Qualifications

• 2+ years supporting adults age 21+ receiving Long-Term Services and Supports (LTSS) (preferred)
• 2+ years of member or provider outreach in a fully outbound call environment (preferred)
• 2+ years processing healthcare/insurance authorizations and coordinating member or provider services (preferred)
• Detail-oriented, adaptable, hands-on learner, and proficient with web-based and CMS systems

Schedule

Monday - Friday: 8 am - 5 pm or 8:30 am - 5 pm (EST)

Pay

$17.84 - $28.02 per hour

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules