Job Description

Salary Range: $18-$22 hourly

Summary

Under the direct supervision of the Lead Case Management Coordinator and the RN, Clinical Supervisor, the Case Management Coordinator performs major clerical work primarily responsible for coordinating care for cases assigned to Nurse Case Manager. Daily work incudes compliance with State, Federal and Health Plan as mandated.

Duties and Responsibilities

• Responsible for opening and closing cases
• Responsible for completing and closing tasks
• Responsible for uploading, documenting pertinent information and documents to member’s file
• Responsible for updating condition codes on AccessPoint
• Responsible for conducting outbound calls for engagement to the members utilizing 3 different method options (Letter, Robotalker, and Live call)
• Accommodate the team with coordinating care for members with their nonclinical needs
• Assists with contacting the member’s medical network for coordination of care purposes
• Ensure all documentation is entered timely and correctly in the members case file
• Ensure the case managers tracker is updated timely and correctly
• Assists with outreach to members for transitions of care
• Sends out requests to provider offices and hospitals for medical records and other required information as directed.
• Logged into Case Management Phone queue
• Assists with the Case Management Right fax distribution
• Retrieves Health Risk Assessments from Health Plans
• Give assistance to shadowing new onboarding TMs
• Aid with generating correspondence letters and Care plan
• Accountable for completing trainings provided by MPM and HP
• Ensure emails are responded to within 24 hours
• Accountable for attending all mandatory team huddles and meetings
• Informs management of any issue gathered from communication
• Participates in other assignments as required
  
  

Minimum Job Requirements

• High school graduate or GED equivalent
• Minimum of two years’ experience in a call center environment; health plan or medical group call center experience preferred.
• Computer Proficiency on Microsoft Word, Excel, and PowerPoint
  
  

Skill and Abilities

• Data Literacy
• Critical Thinking
• Adaptability