Member Care Coordinator

Mindlance; Chicago (IL); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare company is seeking a full-time Remote Health Assessment Coordinator. The role involves conducting health assessments, engaging with members on care plans, and supporting clinicians. Ideal candidates must have a degree in social work or psychology and strong communication skills. Join us to impact member outcomes positively while working in a collaborative environment.

Qualifications

• Bachelor's degree in social work or related field preferred.
• 1 year experience in managed care systems.
• Strong customer service and communication skills.

Responsibilities

• Conduct home health assessments and engage members on health plans.
• Maintain communication with the clinical team and support case management tasks.
• Perform data entry and ensure HIPAA compliance.

Skills

Customer service skills

Verbal communication skills

Written communication skills

Motivational interviewing

Education

Bachelor of Social Work or Psychology

LVN, LPN with 1 year experience

RN

3 years care coordination experience

Tools

Microsoft Office

Job description

full-time remote, but training will be a few days onsite
pay rate should align to conversion salary
telephonic based role

BASIC FUNCTION:This position is responsible for conducting home health assessment, contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities.ESSENTIAL FUNCTIONS:1. Responsible for home health assessments and system updates.2. Perform outreach and follow up attempts to members on their health care plan. 3. Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise.4. Inform and educate members on their program, may use supplied scripts. Complete records in system by performing data entry. Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation). Generate appropriate correspondence and send to member manually, electronically, or telephonically. 5. Conduct check-ins with members to review individual care plan goals.6. Maintain production requirements based on established department business needs. 7. Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate, manage, and close a case within the platform. 8. Receive, analyze, conduct research and respond to telephone and/or written inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customer or send to appropriate internal party. 9. Notify help desk of system issues. 10. Perform data entry function to update customer or provider information. 11. Obtain required or missing information via correspondence or telephone.12. May serve as contact for the various groups regarding claims which involves conducting research, obtaining medical records/letters of medical necessity from TMG, reopen or initiate new cases as needed and refer case to clinicians.13. Support and maintain communications with various in-house areas regarding groups? concerns, i.e.: Marketing, Provider Affairs, and SSD. 14. Communicate and interact effectively and professionally with co-workers, management, customers, etc.15. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.16. Maintain complete confidentiality of company business.17. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested. JOB REQUIREMENTS:? Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.? Knowledge of medical terminology? Experience coordinating member medical related needs, providing assistance to members, and analyzing member needs? PC proficiency including Microsoft Office applications? Customer service skills? Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues? Current state driver license, transportation, and applicable insurance? Ability and willingness to travel

EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”