Care Coordination Technician- Remote in Virginia

sentara; United States; A distancia; USD 30.000 - 45.000; Jornada completa

Descripción de la vacante

Sentara Health Plans is hiring a Care Coordinator Technician- Remote in Virginia. The role supports Care Coordination staff with telephone triage, data entry, and report distribution, coordinating services for members’ plans of care.

The position involves frequent calls and computer work during the 8-hour shift. Requires HS diploma and at least 2 years of administrative experience in a clinical setting, along with knowledge of medical terminology and Medicaid/Medicare benefits.

Formación

• 2 years of administrative experience in a clinical setting is REQUIRED.
• Knowledge of medical terminology and Medicaid/Medicare benefits is required.
• Familiar with Virginia regulatory compliance standards and ability to meet deadlines.

Responsabilidades

• Provide telephone triage and data entry support for clinical and non-clinical information.
• Distribute reports to staff for follow-up and extract data for reports.
• Make routine and ad-hoc calls to members per plan of care and contractual requirements.
• Assist care coordinators in arranging services related to members’ plans of care.
• Schedule Health Risk Assessments and Plan of Care reviews for members.
• Conduct provider outreach for expiring authorizations and assist with equipment/transport coordination.

Conocimientos

Administrative experience

Medical terminology

Medicaid/Medicare knowledge

Regulatory compliance knowledge

Excel

Verbal and written communication

Educación

HS - High School Grad

Herramientas

Excel

Microsoft Office

Jiva

Descripción del empleo

City/State

Norfolk, VA

Work Shift

Multiple shifts available

Overview

Sentara Health Plans is hiring a Care Coordinator Technician- Remote in Virginia!

Status

Full-time, permanent position (40 hours)

Standard work hours

8am to 5pm EST, M-F

Location

Remote in Virginia

Job Description Summary

Care Coordination Technician works in a collaborative role with all members of the professional health care team and with community service agencies to coordinate care for members to improve health outcomes.

• The Care Coordinator Technician has responsibility for providing direct support to Care Coordination staff and members by providing telephone triage for all incoming phone calls, data entry services for clinical, non-clinical information, distributing reports to staff for follow up, extracting data for on-going and ad hoc reports and other duties as assigned by LTSS leadership.
• Makes routine/scheduled and ad hoc/follow-up calls to members in compliance with contractual requirements and the member's plan of care.
• Assists Care Coordinators in arranging services associated with member's plan of care.
• Assigned to a group of 5+ care managers
• Schedule Health Risk Assessments (HRA), Level of Care Assessments, home visit attempts, and Plan of Care reviews for the members
• Conduct provider outreach for expiring personal care authorizations
• Assist with follow-ups on medical equipment, transportation, and post-discharge meal services for the members
• Expected monthly expectation of at least 175 calls per person
• Role requires being on the phone and computer for the majority of the 8-hour shift

Education

HS - High School Grad or Equivalent REQUIRED

Certification/Licensure

None required

Experience

2 years of administrative experience in a clinical setting REQUIRED Knowledge of medical terminology Knowledge of Medicaid and Medicare benefits Familiar with Virginia regulatory compliance standards Ability to meet deadlines in a consistent manner; able to manage multiple deadlines Knowledge of Utilization Management, Care Coordination processes Strong organizational skills; able to multitask and prioritize. Strong written/documentation and verbal skills-detail oriented Detail oriented Experience in scheduling including navigating calendars and utilizing maps to schedule smart drive times preferred Experience in scheduling for multiple providers/team members preferred With Social Services background (CPS, APS, Foster Care, Benefit/Eligibility workers) preferred With Medical Office Experience preferred With Service Facilitators or Personal Care Agency experience preferred With Previous Health Plan experience preferred With Customer service experience within the health care or human services field preferred Proficiency in working with Excel and familiarity with Microsoft applications preferred Experience with Jiva is a plus

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full-time employment is $21.73 - $32.91 hourly. Additional compensation may be available for this role, such as shift differentials, on-call pay, overtime, shift premiums, extra-shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs.

Sentara offers a comprehensive benefits package, including medical, dental, vision, life and disability insurance; 401(k)/403(b) with employer match; paid time off (vacation, sick ti