Care Management Associate

Position: Care Management Associate
Department: Medical Management
Location: New York, NY 10004
Shift: 9:00 AM–5:00 PM
Schedule: Full-time; Monday–Friday; Hybrid
Pay Range: $22-$25/hr.

Required Experience:

• One year of satisfactory full-time experience.
• CDPAP experience specifically requested by the client.
• Analytical experience specifically requested by the client.

Preferred Experience:

• Understanding of medical terminology.
• Knowledge of ICD-9 and CPT-4 codes.
• Prior managed care experience.
• Prior customer service/call center experience.

Required Education:

• High school graduation or evidence of having satisfactorily passed a High School Equivalency Program.

Job Summary:

The Care Management Associate, under the direction of the Team Lead, is responsible for the daily activities of member case intake functions and associated workflow, as well as other duties associated with the coordination of member care for MLTC.

Job Responsibilities:

• Complete missing information from documentation received.
• Confirm conflicting information accuracy in documentation.
• Schedule appointments for Care Management staff.
• Handle incoming and outgoing calls on the MLTCP ACD.
• Maintain member files and track membership status.
• Liaise between client and HHA/PCA/PCS/CDPAP vendors regarding member services.
• Assist members in scheduling necessary medical visits.
• Enter prior approvals and service authorizations into the application system.
• Notify vendors of member service start dates.
• Track and monitor key information identified by the Supervisor/Manager for quality purposes.
• Track and monitor member hospital admissions, nursing home facility admissions, ER visits, and unexpected outcomes.
• Track and process faxes within application systems.
• Track members' short-term absences from geographic areas.
• Notify the Care Manager if a member cannot be contacted.
• Perform other tasks assigned by the Team Lead or management team.

Professional Competencies:

• Integrity and Trust
• Customer Service Focus
• Functional/Technical Skills
• Written/Oral Communications