Care Management Support Coordinator III - J01004

hidalgo, TX 78557

Category: Other Area(s) Job Number: 43905 Location Requirements: Remote

Job Description

Position Purpose:
Works with care management team on 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.

Note: Candidate should be from Remote; Areas to source from- Hidalgo County, Starr County, and Cameron County.

Education/Experience:
Requires a High School diploma or GED
Requires 2 - 4 years of related experience.
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 experienced 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 in-depth 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

Applies in-depth knowledge of care management support activities including care plans and community resources

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

Works with care management team on escalating requests and inquiries to management

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

May support training of new hires
Performs other duties as assigned

Complies with all policies and standards

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Amit Singh

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About hidalgo, TX

Discover exciting job opportunities in the vibrant area around Hidalgo, Texas! Nestled in the heart of the Rio Grande Valley, Hidalgo offers a unique blend of rich culture, warm hospitality, and boundless growth potential for job seekers. Immerse yourself in the region's enchanting charm, from savoring delectable Tex-Mex cuisine to exploring the iconic Hidalgo Arena and catching a show at the historic Border Theater. Embrace the opportunity to advance your career in a thriving community surrounded by scenic parks, like the beautiful Bentsen-Rio Grande Valley State Park, and a lively arts scene with galleries to explore. Join us in discovering the endless possibilities for your professional journey in this dynamic and inviting region!