Care Management Coordinator

Location: Southfield, MI
Date Posted: 09-14-2018
CareNational
Care Management Coordinator 
Detroit, MI
 
Care Management Coordinator  Job Summary:
  • Coordinates follow-up care plans by scheduling needed appointments or enrolling member in related programs
  • Assesses member compliance with medical treatment plans, identifying any barriers and coordinating resolution to ensure that members receive appropriate care, at the appropriate level, in a timely manner
  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
  • Provides information regarding network providers or general health plan or program information when requested
  • Assists customers in navigating relevant websites and encourage and reassure them to become self-sufficient
  • Identifies and refers members to appropriate local, state or federal programs
  • Provide education and status of previously submitted pre-authorizations or pre-determination requests
  • NOTE: This position is NOT involved in any activity which requires advanced interpretation of clinical information, or any other duties that requires clinical licensure by the state

Care Management Coordinator Background:   
  • Requires an education level of at least a high school diploma or GED; Associate’s or Bachelor’s degree is a plus.
  • Requires exceptional telephonic customer service skills, as well as strong computer user skills.
  • At least 3-5 years’ Care Coordination experience, or other healthcare support role with heavy computer & phone use.
  • Requires 1 or more years at a Managed Care Organization (Health Plan, IPA/Medical Group, HMO, TPA/MSO, etc).
  • Requires basic to intermediary familiarity with Medical terminology (1-3 years direct experience).
  • Knowledge of health care delivery system, Medicaid/Medicare and related state programs is required.
  • Computer skills to include Microsoft Word, Excel and basic data entry, including the ability to learn new computer system applications.
  • Must have a minimum of 30-40 wpm typing with a high level of accuracy.
  • Ability to work regularly scheduled shifts within hours of operation (flexible scheduling for later start times is available!)
 
#ADMIN
 
KAYLA ROGERS
ACCOUNT MANAGER
CareNational
kayla@carenational.com
623.201.8732 (CALL – TEXT – FAX)
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