BusinessOperations - Care Management Support Coordinator II - J01003

Position Purpose:
Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.

Education/Experience:
Requires a High School diploma or GED
Requires 1 2 years of related experience



License/Certification:

For Florida-Sunshine Health Plan - All interactions with members are done telephonically


Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service

Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service

May apply working knowledge of assigned health plan(s) activities and resources

Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols

Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship

Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed

Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs
Performs other duties as assigned

Complies with all policies and standards

EEO:

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

==========

Position Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines. Education/Experience: Requires a High School diploma or GED Requires 1 2 years of related experience License/Certification: For Florida-Sunshine Health Plan - All interactions with members are done telephonically Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service May apply working knowledge of assigned health plan(s) activities and resources Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs Performs other duties as assigned Complies with all policies and standards
Story Behind the Need
Typical Day in the Role
Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?	This position will serve as an administrative organizer for identification of utilization through the tasks, and working to develop the process that incorporates that role into a major component of compliance and meeting the required follow ups. Included but not limited to reviewing the task as they come across, interdepartmental collaboration, outreach to members/providers, ensuring proper follow up post transitions, etc. " Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service " Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service " May apply working knowledge of assigned health plan(s) activities and resources " Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols " Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship " Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed " Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs " Performs other duties as assigned " Complies with all policies and standards What are performance expectations/metrics: " 1:1 s with manager " Evaluations " Quality and timeliness of documentation " Successful completion of assigned projects. " Upholding Centene values and expectations for professional behavior " Metrics must be met weekly to meet the expectation that is set by the department.
Candidate Requirements
Required: High School diploma or GED			Preferred:
Required:			Preferred:
Years of experience required: 1 2 years of related experience Disqualifiers: Additional qualities to look for:
Top 3 must-have hard skills stack-ranked by importance	1	Medical background
	2	customer service representative
	3	Managed care environment
Candidate Review & Selection
Shortlisting process Candidate review & selection Interview information Onboard process and expectations	Projected Manager Candidate Review Date:			1-2 days post shortlisting
	Type of Interviews:			Teams Camera on
	Required Testing or Assessment (by Vendor):			.