Program Coordinator 1

BCForward is currently looking for Program Coordinator 1 (Remote)

Position Title: Program Coordinator 1 (Remote)

Location: Remote

Expected Duration: 3+ months.

Monday - Friday 8:00 a.m. - 5:00 p.m. EST

Pay Rate: $18/hr

Estimated Start Date: 4/22/2024

Position Purpose:

• Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.

Education/Experience:

• High school diploma or equivalent.
• 2-3 years managed care setting, medical office or facility setting with demonstration of medical administration duties.
• Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer.
• Knowledge of medical terminology.

Required Education/Experience -

• Bachelor's degree in nursing, social sciences, social work, or a related field.
• 1 year supervised clinical experience in a human services field.
• Initiate authorization requests for output or input services in keeping with the prior authorization list.
• Research claims inquiry specific to the department and responsibility.
• Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results.
• Assess and monitor inpatient census.
• Screen for eligibility and benefits.
• Identify members without a PCP and refer to Member Services.
• Screen members by priority for case management (CM) assessment.
• Perform transition of care duties to include but not limited to, contact the members attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.
• Coordinate services with community based organizations.
• Attend marketing and outreach meetings as directed to represent the plan.
• Produces and mails routine CM letters and program educational material.
• Data enter assessments and authorizations into the system.

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 220630 when responding to this ad.