Case Management Assistant - The Health Plan

Summary
We are searching for a Case Management Assistant to assist the Case Manager in the identification of member needs, initiation of member contact, provision of member and provider education and coordination of community resources to promote optimal health.
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Qualifications
Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s, unless approved for a medical or religious exemption.

• Two years of call/contact center experience preferred
• Two years of experience in Case management, community outreach, healthcare, and/or health insurance experience OR
• High school diploma or GED required
• Three years of general administrative experience required

Responsibilities

• Documents in current case management system.
• Responsible for ongoing analysis of claims data to identify needs for quality/performance
• Provides Support for Case Management Services.
• Completes all eligibility and benefit data available on members before routing to Case Manager or Transition Specialist.
• Screens and evaluates all calls and refers as necessary to Case Manager, Social Worker, or Transition Specialist and/or supervisor.
• Initiates member phone calls daily and identifies issues and refers to Case Managers and other health plan departments as indicated.