Care Management Support Coordinator II (Spanish Remote - MST)

Care Management Support Coordinator II (Spanish Remote - MST)

BCForward is currently looking for Care Management Support Coordinator II in Remote (Arizona/Texas Only)

Position Title: Care Management Support Coordinator II (Spanish Remote - MST)

Location : Remote - MST (Arizona/Texas only)

Anticipated Start Date: 10/28

Expected Duration: 6 months

Job Type: Contract with an extension

Shift: 11:30am-8:00pm EST.

Pay Rate: $24.75/hr on W2

Job Description:

Supports 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.

The Community Connections Help Line (CCHL) is a resource and referral source for all callers with social service needs. Not only does the Community Connections Help Line assist WellCare members, but they are also open to the public, assisting everyone and anyone with social service needs. If a caller is in need or requesting additional assistance with one of the Social Services, you will assist the caller with the following:

Assistance Categories - Below is a brief description of the different services our CCHL team can assist callers by locating resources.

• (Clothing, Financial, Food)
• Community Services
• Family Services
• Health/Medical Services

Examples of How CCHL assisted and helped our members and even non-members.

Example 1:

Caller called the Community Connections Help Line needing wheelchair accessible transportation to visit his wife in a nursing home. Liaison provided a referral to New Freedom Transportation Service

on October 1, 2015. Liaison called the caller to follow-up on the given referrals. Caller stated that the agency can transport him to and from the nursing home for $1.00 each way. Caller stated that sometimes the agency is busy and cannot take him, but most of the time they can. This is invaluable as it promotes positive mental health and thus promotes better physical health, both for the Caller and his wife.

Example 2:

Caller called the Community Connections Help Line requesting medication assistance for topical prescription medication Valchlor. Caller had $2,500 co-pay, which they could not afford. Caller was able to connect with Caring Voices Coalition and the caller was able to receive his medication for free. The caller was very grateful for the help he received from CCHL and now has the peace of mind that he would not have to go without his medication. Caller's physical health and emotional well-being were enhanced.

Describe the performance expectations/metrics for this individual and their team:

• Inbound AHT
• Outbound AHT
• Quality
• SLA 80% in 30 seconds or less (group goal not individual)
• Limiting wrap up if it begins to affect overall AHT (AHT is calc'd as time on the phones plus wrap up activities)
• Monthly average
• Goals are set each month by leadership and are subject to change depending on the needs of the department.
• Currently, Inbound AHT 90%

Required Skills/Experience

Bi-Lingual Candidate (Spanish)

High school diploma or equivalent

2-3 years managed care setting, medical office or facility setting with demonstration of medical administration duties and call center experience.

Knowledge of medical terminology in Medicare/Medicaid field.

Preferred Skills/ Experience:

Customer service- Medicare/Medicaid services

Providing referrals for Medicare is a huge PLUS, one of the largest struggles is new hires not understanding which referrals are appropriate for the given situation

Referral knowledge or experience, providing referrals. Good Tenure with previous employers.

List qualifications, what programs have they used? Wants this person to be able to be a multi-tasker. (Citrix, Microsoft, Teams, Excel)

Software Skills Required: **Typing Per Minute is appliable**

Education/Experience:

Requires a High School diploma or GED

Requires 1 - 2 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 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

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

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About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 229520 when responding to this ad.

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