Job Description

Support the daily operations of the Virtual Hub by providing program interventions for identified at-risk members under clinical team direction Provide administrative support to a clinical team responsible for a defined population of members/beneficiaries Process and triage member, caregiver, provider, internal, and external customer calls in a call center environment Handle inbound and outbound calls and transactions supporting clinical staff and assigned teams Assist with member enrollment in care management programs Create, update, maintain, and close tasks; route cases to appropriate Care Coordinators Collaborate with members, caregivers, physicians, staff, and health care professionals to provide care coordination Implement program interventions, document activities, assist with authorizations, make follow-up calls, and send educational materials and letters Help members and caregivers resolve problems and reduce barriers to care Identify community-resource gaps and communicate them to the Care Coordinator Identify members with Care Gaps/HEDIS-related conditions and assist with scheduling and community-resource referrals Reinforce prescribed treatment plans, goals, and strategies to overcome barriers Enter timely and accurate data into Care Management applications Facilitate access to entitlement programs and community resources Attend educational offerings and maintain knowledge of technology, disease self-management protocols, and community resources Perform other related duties assigned by clinical staff, Supervisor, Manager, or Director Requirements Health Science Certification or Associate degree in a health care related field required Bachelor’s degree preferred Two years of experience working in an office environment required Strong organization skills Excellent customer service and interpersonal skills on phone and in-person Ability to handle multiple tasks simultaneously Ability to maintain confidentiality of all company and member information Knowledge of medical terminology Proficiency working with computers and various computer software applications Proficient PC skills in a Windows-based environment, including word processing, spreadsheets, and database programs Ability to work Monday through Friday, 8:00 a.m. to 4:30 p.m. Core Competencies Demonstrates expertise in care coordination, member enrollment, and administrative support within a clinical environment. Proficient in managing member interactions, data entry, and utilizing community resources to enhance patient care. Highest-signal resume keywords Health Science Certification Care Coordination Customer Service Skills Medical Terminology Knowledge Data Entry Proficiency Hard Skills Care Management Applications Task Management Community Resource Referrals HEDIS-related Conditions Identification Program Interventions Implementation Soft Skills Strong Organization Skills Interpersonal Skills Ability to Handle Multiple Tasks Confidentiality Maintenance Certifications & Qualifications Health Science Certification Associate Degree in Health Care Related Field Industry Keywords Clinical Team Support Care Management Programs Member Enrollment Community Resources Entitlement Programs Tools & Technologies Windows-based Environment Word Processing Software Spreadsheet Applications Database Programs #J-18808-Ljbffr Jobtailor

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