Care Management

Pyramid Consulting, Inc.; Avondale Estates (GA); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare organization seeks a Care Management professional for a remote contract position. Responsibilities include collaborating with medical staff, managing member communications, and handling call center operations. Ideal candidates will have experience with medical insurance, strong communication, and organizational skills. Competitive pay range of $22-$24/hour with benefits such as health insurance and a 401(k) plan.

Benefits

Health insurance (medical, dental, vision)

401(k) plan

Paid sick leave

Qualifications

• Experience with medical insurance and member outreach.
• Call center experience required.
• Ability to handle high call volumes and meet performance indicators.

Responsibilities

• Collaborate with internal staff to coordinate schedules and obtain authorizations.
• Support care management activities and manage member communications.
• Handle inbound calls and resolve issues efficiently.

Skills

Communication skills

Organizational abilities

Problem-solving skills

Customer service

Education

High school diploma or GED

Tools

Trucare

phone systems

Job description

Immediate need for a talented Care Management professional. This is a 6+ months contract opportunity with long-term potential, located remotely in the U.S. Please review the job description below and contact me ASAP if interested.

Job ID: 25-71237

Pay Range: $22 - $24/hour. Employee benefits include health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Collaborate with internal medical directors and clinical nursing staff to coordinate peer-to-peer schedules and obtain authorizations for member services.
• Support administrative care management activities, including outreach, inbound call handling, and scheduling services. Act as a point of contact for members, providers, and staff to resolve issues and document member records per current regulations.
• Handle high call volumes to meet service levels.
• Navigate multiple systems during live calls to schedule peer-to-peer requests for internal medical providers.
• Communicate effectively via Teams chats, emails, and other channels.
• Work in a fast-paced environment with high call volume, demonstrating familiarity with request completion processes and collaboration with leadership.
• Assist providers and members in obtaining and overturning authorizations.
• Enhance communication skills and system navigation abilities, gaining experience in adapting to process changes.

Key Requirements and Technology Experience:

• Experience with Trucare, medical insurance, member outreach, call centers, and phone systems.
• High school diploma or GED.
• Call center experience, medical insurance knowledge, customer service, and problem-solving skills.
• Disqualifiers include lack of a quiet workspace and poor internet quality.
• Performance indicators: average handle time (target 7 minutes), average hold time (target 1 minute).
• Strong communication skills, organizational abilities, and coachability.

Our client is a leading healthcare organization. We are currently interviewing for this and similar contract positions. If interested, please apply online for immediate consideration.

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