Provide support to medical, behavioral, and social support staff to determine needs, eligibility, and services for members. Conduct screening and risk assessment interventions per program guidelines.
Job Responsibilities
Identify special needs members through the completion of health screens and other resources.
Work with community outreach/member advocates to coordinate member care.
Educate providers and community resources on program components and available support services.
Educate members with special needs to foster compliance with program and positively impact outcomes.
Conduct site visits as appropriate for programs and provide support to other special programs.
Assist with modification and management of care plans under the direction of a Registered Nurse in conjunction with member, medical consenter, or caregiver, Department of Family and Protective Services (DFPS) caseworker and family, if applicable, as well as the managing physician.
Qualifications
High School Diploma or GED.
Medical-Long Term Services and Supports Background, Working with the Aging, Blind and Disabled Population.
Microsoft 365 applications including Outlook, Excel, Word, etc., Avaya soft phone knowledge.
MCO Medicaid STAR+PLUS insurance knowledge.
Call center experience is necessary; workers are expected to be on the phone for the shift and will need to follow their schedule in a timely manner.
Preferred Qualification
Background in Managed care.
Preferred BA in Social Work or Healthcare Mgmt., LVN, CNA, CMA, RT, Pharmacy Tech.
Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
Staffing and Recruiting
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