Care Management Support Specialist

Healthfirst; Florida; On-site; USD 35,000 - 52,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k contributions

Job summary

Healthfirst is seeking a Support Coordinator to assist CARE/case managers with non-clinical tasks, including creating cases and events, providing telephonic outreach to members and providers, and handling member mailings.

You will support teams such as Care Management, Utilization Management and Behavioral Health, performing calls and documenting activities to improve quality and cost outcomes.

Qualifications

• High School diploma or GED equivalent.
• Experience in a customer service environment.
• Experience in fast-paced environment with multiple priorities.
• Effective verbal and written communication with good grammar, spelling, and punctuation.

Responsibilities

• Conduct outreaches for newly enrolled members to review services, DME, and requests.
• Review intake documents for pre-approved services and escalate discrepancies.
• Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify issues needing clinical escalation.
• Initiate and finalize authorizations in Trucare for pre-approved services and DMEs; update/discontinue as applicable.
• Document calls to and from members for benefit questions, scheduling, inquiries and grievances.
• Document calls with providers regarding authorizations, referrals, visits, tests and faxed care plans.
• Educate members and providers on requirements for service approval.
• Manage a large caseload with proactive communication of member needs and monitoring outcomes.
• Coordinate with other departments to reconcile onboarding issues.
• Perform additional duties as assigned.

Skills

Customer service

Communication

Multitasking

Written communication

Education

High school diploma or GED

Associate degree or certification

Tools

Trucare

Salesforce

HHAXchange

DocuSign Epaces

Sharepoint

Microsoft Office Suite

Job description

Healthfirst is seeking a Support Coordinator to assist CARE/case managers with non-clinical tasks, including creating cases and events, providing telephonic outreach to members and providers, and handling member mailings.

You will support teams such as Care Management, Utilization Management and Behavioral Health, performing calls and documenting activities to improve quality and cost outcomes.