Community Programs, Customer Support/Service, Documentation, Health Plan, Medical Office Administration, Needs Assessment, Performance Management, Process Improvement, Registered Nurse (RN), Risk Analysis, Special Needs
LOCATION
McAllen, TX
POSTED
1 day ago
Summary:
Work Mode: 100% Remote
Duration: 6 months, possible extension or conversion
SHIFT: Mon - Fri 8am - 5PM (Possible OT)
Responsibilities:
Provide support to medical, behavioral, and social support staff to determine needs, eligibility, and services for members.
Conduct screening and risk assessment interventions per program guidelines.
Identify special needs members through the completion of health screens and other resources.
Work with community outreach/member advocates to coordinate member care.
Educate providers and community resources on program components and available support services.
Educate members with special needs to foster compliance with the program and positively impact outcomes.
Assist with modification and management of care plans, medical consenter or caregiver, and family, if applicable, as well as the managing physician.
Ensure efficiency, quality, and compliance with the timeliness of required assessments and documentation.
Engage in process improvement to enhance overall performance concerns and improve member outcomes.