Care Coordinator III

BCforward is currently seeking a highly motivated Care Coordinator III for an opportunity in Remote -SC!

Position: Care Coordinator III

Location: Remote -SC

Duration: 6 Months

Pay-Rate: $18/Hr. on W2

Shift: 8:00 - 5:00 OT not required.

Position Purpose:

Works with senior care management team to support care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically or through home-visits.

Education/Experience:

• Requires a High School diploma or GED
• Requires 2 - 4 years of related experience

License/Certification:

• For Illinois Youth Care Contract: Bachelor's degree in nursing, social sciences, social work, or related field; One (1) year of supervised clinical experience in a human-services field
• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plans
• Develops in-depth knowledge of care management services including responding to some complex or escalated issues
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care
• Performs service assessments/screening for members with some complex needs and documents the members care needs.
• Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed
• Works with care management team with triaging, adjusting, and escalating complex requests to management
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community cased organizations, and Disease Manager
• Provide education on benefits and resources available
• May assist with training and development needs
• Performs other duties as assigned
• Complies with all policies and standards

Required:

Must haves: 2+ years of call center experience, preferably in healthcare.

Nice to haves: HEDIS, STARS, CAHPS, NCQA , MEDICARE and/or MEDICAID experience

Performance indicators: Make 70 calls/day (10 calls per productive hour); Maintain 99.5% quality score; adhere to attendance guideline

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 240533 when responding to this ad.

---