BusinessOperations - Care Management Support Coordinator II - J01003

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 EEO “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.” ================ Position Purpose Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling assessments. Serves as a point of contact to members, for scheduling purposes 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 Complies with all policies and standards Story Behind the Need What is the purpose of this team? Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative? Call center type role, making outbound and receiving inbound calls (daily goal of at least 30 members or more per day) Speaking with members and legal representatives Purpose of call: to schedule assessments for Star Kids Product (potentially Star Plus, Star Health, etc) 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. Typical Day in the Role Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique? Performance expectations/metrics for this individual and their team: Attendance is important, timeliness and professionalism necessary 30 members/day (attempting to schedule or scheduling them) Strict turnaround time for this department – if not met, subject to potential damages by the state Fast-paced environment and expected to follow up within a certain timeframe Have experience in handling high call volume Ability to multitask, members and system programs First Day Details May be required to attend a morning training by the IT team to set up equipment Once activated in the system, connect with Supervisor and Team Lead Provide an overview of what the team does. Go over rules/expectations. Centene University training modules to complete compliance items Training is in-house (completed by Scheduling Leadership and mentor schedulers) rather than with a set Centene trainer Assigned lunch time and break times given Candidate Requirements Education/Certification Required: HSD or equivalent Preferred: n/a Licensure Required: n/a Preferred: n/a Years of experience required Requires 1 – 2 years of related experience Additional qualities to look for: Call center experience Computer knowledge such as Outlook, Excel Bilingual would be a preference but not a requirement Good customer services skills. Call center experience may benefit as we do outbound calls all day as well as receive inbound calls. Fast-paced environments, not just working at own pace in a doctor’s or medical office without being held to strict deadlines Home health or managed care experience was previously required, but we are willing to train on this and open a wider net for candidates like other managers in this area! Top 3 must-have hard skills stack-ranked by importance 1 High call volume experience. Need to be comfortable with this, does not necessarily need the experience previously. 2 Customer Service experience 3 Computer literate, good typing skills (send candidate typing test if you are concerned on this skill with a candidate) - Microsoft Office, Excel, Outlook experience required Candidate Review & Selection Shortlisting process Candidate review & selection Interview information Onboard process and expectations Projected Manager Candidate Review Date: 1-2 days post shortlisting Type of Interviews Teams, phone, etc. Required Testing or Assessment (by Vendor): Typing test, basic computers skills test, etc. Next Steps