Care Coordinator II

Care Coordinator II

BC Forward is looking for HEDIS Coordinator (Remote) in Florida

Position Title: HEDIS Coordinator (Remote)

Location : REMOTE - Tampa Florida
Anticipated Start Date: 1/6
Expected Duration: 6 months

Job Type: Contract with possible extension and Temp to Hire

Shift: Monday - Friday 9:00 am - 6:00 pm

Pay Rate: $25/hr on W2

Need: Previous HEDIS AND healthcare experience is required

Note: Planned PTO: New hires should not have any planned PTO during the duration of the assignment, except for official holidays when Client is closed. The team requires full support, so please ensure candidates do not have any scheduled time off around the holidays or for the entire assignment period.

Job Description:

Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):

• Making outbound calls (main responsibility) to CMS membership (T5) UTR - unable to reach population.
• Attempting to call the families to establish contact information for CMS members
• Calling providers, etc.

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

• Caseload will be between 100-120 members which will need to be completed call attempts.
• Every member gets a (3) attempt contact outreach as well as PCPs, and providers (9) attempts per member
• Must be completed with all their calls by the end of the third week of each month.
• Will be audited in regards to their calls to ensure that they are completing the quality standards required.
  

Required Skills/Experience:

At least 2 years of related experience in a medical environment.

Experience working in a call center environment.

Proficient in medical terminology.

Comfortable communicating with members, providers, and PCPs.

Preferred Skills/Experience:

Experience with HEDIS (Health Effectiveness Data and Information Set).

Previous remote work experience.

Education Requirements:

• Required: High School diploma or GED.

Education Preferred:

• Additional certifications or training in healthcare or medical-related fields (optional, depending on role).

Software Skills Required:

• Basic proficiency in Excel (ability to filter, sort, and analyze reports).
• Proficient in Outlook for email communication.
• Familiarity with TEAMS for team communication and collaboration.

Position Purpose
The primary role of this position is to support care management activities and teams to ensure the delivery of services by healthcare providers and partners, promoting continuity of care and member satisfaction. This position involves direct interaction with members through telephonic outreach or home visits, documenting care plans, service activities, and assisting in coordinating care.

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Key Responsibilities:

• Member Outreach: Engage with members via phone or home visits to discuss care/service plans, address questions or concerns, and provide ongoing education related to their care.
  
• Care Coordination: Coordinate care activities in line with care/service plans, collaborating with healthcare providers, community partners, and caregivers to address changes or progress as needed.
  
• Member and Provider Support: Address inquiries or concerns from members or providers related to care plans and services, facilitating communication and ensuring service delivery.
  
• Collaboration: Communicate effectively with care managers, healthcare practitioners, and other relevant stakeholders to ensure seamless member services and continuity of care.
  
• Service Assessments: Support service assessments/screenings for members and document care needs accordingly.
  
• Documentation: Maintain accurate member records in compliance with state and regulatory requirements, ensuring timely distribution to providers as necessary.
  
• Compliance: Adhere to standards of practice and policies that comply with contractual obligations, regulatory guidelines, and company standards.
  
• Referrals and Education: Identify member needs and refer to appropriate resources, such as Care Managers, community organizations, or Disease Managers. Provide education on available benefits and resources.
  
• Other Duties: Perform additional tasks as assigned in support of care management functions and team needs.
  

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Education/Experience:

• Education: High School diploma or GED required.
• Experience: 1-2 years of related experience in care coordination, member support, or healthcare services.

Important Information for New Hires:

• Planned PTO: New hires should not have any planned PTO during the duration of the assignment, except for official holidays when Centene is closed. The team requires full support, so please ensure candidates do not have any scheduled time off around the holidays or for the entire assignment period.
  
• Work Setup: Candidates must have a designated area to work. They should be able to set up a private and dedicated office space to ensure productivity and minimize distractions.
  
• Equipment Requirements: New hires must have the following:
  
  • Monitors (2)
  • Docking station
  • Keyboard
  • Headset

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.

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 232081 when responding to this ad.

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