REMOTE Case Management Associate (Bi-Lingual) - Maternity

ProgenyHealth, LLC; United States; Remote; USD 40,000 - 55,000; Full time

Job summary

A leading company is seeking a fully remote Case Management Associate who is bi-lingual in Spanish to assist in managing case functions. The role involves telephonic outreach, eligibility monitoring, and database management. Candidates should have 1-3 years of healthcare customer service experience and strong communication skills. The position offers a supportive team environment with benefits including 401K and medical coverage.

Benefits

401K with company match

Medical and dental benefits

Long Term Disability

Paid Time Off

Qualifications

• 1-3 years of experience in customer service in a healthcare environment.
• Fluent in English and bi-lingual in Spanish required.

Responsibilities

• Conducts outreach and follow-up calls to members and providers.
• Documents member and provider information in the database.
• Attends ongoing training sessions related to Quality initiatives.

Skills

Customer Service

Problem Solving

Communication

Tools

Outlook

Excel

PowerPoint

Word

Job description

All Jobs > REMOTE Case Management Associate (Bi-Lingual) - Maternity

Fully Remote • Remote Worker - N/A

Description

This position has a Spanish bi-lingual requirement. .

Job Role

The Case Management Associate will assist the Case Management department in the administration of CM functions to include telephonic outreach to members; monitoring of member eligibility; updating database information and research of support services for families. This is a full-time position with five 8- hour workdays per week, between the times of 8:30 am to 7:00 pm Monday-Friday. The CMA reports to the Case Management Engagement Supervisor. In addition, hours for this position will be in Central Time Zone.

Job Responsibilities:

• Works to support the Case Managers in developing open communication with members.
• Freely helps and directs callers to the correct staff member in a friendly, helpful, and courteous manner using principles of good customer service.
• Verifies member eligibility following appropriate ProgenyHealth policies, procedures, and workflows.
• Conducts approximately 35 outreach and follow-up calls daily to members and providers as directed by CM Leadership to: 1) Introduce Maternity CM program, mobile App and initiate intake screening tool. 2) Assist with obtaining necessary information to support CM activities (member demographics, provider contact information, researching community resources). 3) Transfer member to Case Manager or Care Coordinator for assessment completion or schedule an appointment for the member to speak with them at a later date and time.
• Documents member and provider information and calls in the medical management database as needed with member and provider data.
• Data entry into client-based systems as directed by CM Leadership.
• Completes scripted introduction calls to Provider office.
• Transfers any questions of a clinical nature from member or provider to Nurse Case Manager.
• Directs members to client point of contact for complaint calls and documents information received and notifies Supervisor. Assists with research of these issues if asked to do so by Supervisor.
• Attends and participates in meetings to discuss Quality Improvement updates and concerns.
• Attends ongoing training sessions related to Quality initiatives and participates in Quality Improvement projects as needed.
• Advises supervisor immediately, if a quality-of-care issue is identified.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality and PHI disclosure.

Requirements

Qualifications

• 1 – 3 years of experience in customer service in a healthcare environment.
• Must be fluent in English.
• Bi-lingual in Spanish required.
• Call center (outbound) experience strongly preferred.
• Insurance/payor experience preferred.
• Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas as well as interact professionally and effectively with members, clients, and staff from all departments within and outside the company.
• Problem solving skills with the ability to look for root causes and implementable, workable solutions.
• Must be proficient at an intermediate to advanced level in Outlook, Excel, PowerPoint, & Word.
• Must be self-motivated and willing to learn multiple tasks.
• Must be well-organized and able to prioritize tasks.
• Must have commitment to excellence in customer service.

Our team is our most important asset. some of the benefits we offer our team are:

• 401K with company match
• Medical and dental benefits
• Long Term Disability
• Paid Time Off

ProgenyHealth positively recruits people from diverse backgrounds, including individuals with disabilities - if you need an accommodation to interview, please contact us by email: [e-mail]

All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.