Care Management Support Specialist

HealthFirst; Pennsylvania; On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401k contributions

Job summary

HealthFirst is seeking a Support Coordinator to assist care/case managers with non-clinical tasks, including case creation, outreach to members, providers and community organizations, and handling faxed requests. You will support a designated clinical team and help ensure smooth service delivery.

You will manage a large caseload, document calls, educate members and providers on service requirements, and work to improve quality and cost outcomes within a patient-centric care environment.

Qualifications

• High School diploma or GED equivalent.
• Experience in a customer service environment.
• Strong verbal and written communication with good grammar, spelling, and punctuation skills.
• Associate Degree/Certification in a related field.
• English proficient with Mandarin/Cantonese.
• Knowledge of medical terminology.
• Knowledge of Trucare, Salesforce, HHAXchange, DocuSign Epaces, Sharepoint.
• Experience in managed care or healthcare Call Center or Care/Case Management.
• Experience with Microsoft Office Suite applications including Excel, Word, Outlook, and MS Teams.
• Demonstrated ability to document calls into a computer system.

Responsibilities

• Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests
• Review intake documents for pre-approved services and elevate discrepancies as needed
• Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM.
• Handle and accurately document calls to and from members to assist with benefit questions/issues, schedule appointments, assessment inquiries, service issues and grievances
• Handle and accurately document calls to and from providers regarding authorizations initiation/updates, referrals, visits, tests, and faxed care plans
• Provide education to members and providers regarding requirements for approval of service requests
• Manage a large caseload while communicating member issues or needs and monitoring screening of members effectively to improve quality and cost outcomes

Skills

Customer service experience

Communication skills

Bilingual English/Mandarin/Cantonese

Medical terminology

Call Center experience

Documentation skills

Education

Associate Degree/Certification in a related field

High School diploma or GED

Tools

Trucare

Salesforce

HHAXchange

DocuSign Epaces

Sharepoint

Microsoft Office Suite (Excel, Word, Outlook, MS Teams)

Job description

HealthFirst is seeking a Support Coordinator to assist care/case managers with non-clinical tasks, including case creation, outreach to members, providers and community organizations, and handling faxed requests. You will support a designated clinical team and help ensure smooth service delivery.

You will manage a large caseload, document calls, educate members and providers on service requirements, and work to improve quality and cost outcomes within a patient-centric care environment.