Job Description
Immediate need for a talented Care Management Support Coordinator II . This is a 06+months contract opportunity with long-term potential and is located in McAllen TX(Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID: 25-67878
Pay Range: $16 - $17.50/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
- From the manager: During training Cameras must be on and the Employee must be in front of the camera where we can see from their shoulders up.
- Note: This is a remote position that will require you to have a location that is free from all distractions and secure as you will be discussing people private information.
- 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
- The CM Support Coordinator II will be responsible for making outbound calls to SHP S+P Members to follow-up authorizations for long term services/supports and specialized medical equipment, with the purpose of verifying if members have received the service or item and if they are satisfied.
- The CM Support Coordinator II will be responsible for documenting these follow-up calls appropriately in the system of record as well as a tracking log.
- The CM Support Coordinator II will also be responsible for redirecting or warm transferring members to other departments within HealthPlan depending on any needs discussed during the follow-up call.
- Fast pace environment
- Individual worked assignment , call center.
Key Requirements and Technology Experience:
- Key Skills; Star Plus, Member service representative, Member outreach
- High School diploma.
- 30 WPM, MCO or other managed care health plan experience, StraPlus,
- 1+ years of healthcare experience
- Call center experience.
Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here .
Job Tags
Contract work, Local area, Immediate start, Remote job,