Care Coordinator II - J01000

• Requires a High School Diploma or GED
  
• Requires 1-2 years of related experience
  

• Florida - Sunshine Health Plan: All interactions with members are conducted telephonically.
  
• Arkansas - Total Care Plan: This position is designated as safety-sensitive and requires a valid driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in Arkansas or a border city. Travel: 30% required.
  

• Provide outreach to members via phone or home visits to engage them in care plan/service plan discussions, including next steps, available resources, and addressing questions or concerns related to recommended care.
  
• Coordinate care activities based on the care plan/service plan and collaborate with healthcare and community providers, partners, and members/caregivers as needed to accommodate changes or progress.
  
• Serve as a support contact for various member or provider inquiries, requests, or concerns related to the care plan/service plan.
  
• Communicate with care managers, practitioners, and others to facilitate member services and ensure continuity of care.
  
• Support performing service assessments/screenings for members and documenting care needs.
  
• Document and maintain member records in accordance with state and regulatory requirements, ensuring proper distribution to providers as needed.
  
• Follow standards of practice and policies compliant with contractual and regulatory guidelines.
  
• Identify needs and make referrals to Care Managers, community-based organizations, and Disease Managers.
  
• Provide education on benefits and available resources.
  
• Perform other duties as assigned.
  
• Comply with all company policies and standards.
  

• Health Plan: Sunshine State Health Plan
  
• Onboarding: New hires will meet with their supervisor for expectations and department overview. Upon completing orientation, they will be aligned with a preceptor for 1:1 training (beginning on day one).
  
• Training Support: During the first month, new hires will meet weekly with their leader to discuss training and performance.
  
• Team Culture: The team values open communication-daily chats and team interactions ensure consistent support during onboarding and beyond.
  

• Conduct outbound quarterly calls to members to complete follow-up questions.
  
• Manage assigned cases each month.
  
• Perform research to identify member information and connect with providers when necessary.
  
• Make three outreach attempts per member (Day 1, Day 2, Day 3). If contact is not made, follow up with the PCP to verify contact information.
  
• May receive stretch assignments depending on workload volume.
  
• Expected to complete 50-75 calls per day.
  
• Submit a daily production report through Outlook.
  
• Work Environment: Remote. However, if unable to work from home due to issues such as power outages, equipment malfunctions, or internet connectivity problems, the employee must work from the office.
  
  • Office Location: 8745 Henderson Rd, Tampa, FL 33634 (other office locations include Orlando, Miami, or Tampa area Welcome Centers).
    

• Highly transparent and supportive team culture.
  
• Supervisors ensure new hires feel supported and maintain open communication.
  
• Must understand and respect the remote work environment.
  
• Team utilizes Excel regularly-general technology experience is required, but training and coaching will be provided.
  
• Upon conversion, employees gain access to LinkedIn Learning (including PMI courses) to enhance their professional growth and resume.
  

• Required: High School Diploma or GED
  
• Preferred: N/A
  

• Required: N/A
  
• Preferred: N/A
  

• Bilingual (Spanish)
  
• 2+ years in healthcare or managed care background
  
• Comfortable with outbound/inbound calling
  
• Ability to handle high-volume calling (doctor's office/front desk experience does not apply)
  
• General technology experience: Excel, Outlook, Word, Teams
  

• Bilingual in Spanish or Creole
  
• Previous work-from-home experience
  

• Missing or incomplete experience (e.g., Centene contract experience, recent work history, etc.)
  
• Employment gaps (6-8 months) must be explained (e.g., maternity leave, caregiving, illness, termination, or voluntary departure).
  
• Education details must be accurate-all education should be listed, even if only a High School Diploma is required.
  

• Ability to multitask effectively (e.g., making calls while taking notes).
  
• Professional presentation and communication, even in a remote setting (attire, demeanor, tone).
  
• Proper handling of confidential medical information.
  
• Must have a dedicated and professional home office setup conducive to productivity.
  

Interested candidates please send resume in Word format Please reference job code 244843 when responding to this ad.