Healthcare Coordinator Jobs

Job Title: Member Care Coordinator

Duration: 06 Months (Contract to hire)

Location: This position is remote in IL

Pay rate starts from $28/hr.

Basic Function:

This position is responsible for conducting home health assessment, contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities.

Essential Functions:

• Conduct check-ins with members to review individual care plan goals.
• Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation).
• Perform data entry function to update customer or provider information.
• Complete records in system by performing data entry.
• Maintain complete confidentiality of company business.
• Process information from member or provider to determine needs/wants and ensure customer questions have been addressed.
• Responsible for home health assessments and system updates.
• Receive, analyze, conduct research and respond to telephone and/or written inquiries.
• Obtain required or missing information via correspondence or telephone.
• Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise.
• Required Qualification(s): LPC, LPN, LCPC, LCSW
• Respond to customer or send to appropriate internal party.
• Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate, manage, and close a case within the platform.
• Notify help desk of system issues.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Inform and educate members on their program, may use supplied scripts.
• Maintain production requirements based on established department business needs.
• May serve as contact for the various groups regarding claims which involves conducting research, obtaining medical records/letters of medical necessity from TMG, reopen or initiate new cases as needed and refer case to clinicians.
• Generate appropriate correspondence and send to member manually, electronically, or telephonically.
• Support and maintain communications with various in-house areas regarding groups’ concerns, i.e.: Marketing, Provider Affairs, and SSD.
• Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
• Perform outreach and follow up attempts to members on their health care plan.
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.

Job Requirements:

• Ability and willingness to travel.
• Current state driver license, transportation, and applicable insurance.
• Customer service skills.
• Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues.
• PC proficiency including Microsoft Office applications.
• Knowledge of medical terminology.
• Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.
• Experience coordinating member medical related needs, providing assistance to members, and analyzing member needs.

About Us

Established in 2004, SPECTRAFORCE is one of the largest and fastest-growing diversity-owned staffing firms in the US. SPECTRAFORCE is built on the concept of “human connection,” defined by our branding tagline NEWJOBPHORIA®, which is the excitement of bringing joy and freedom to the work lifestyle so our people (and clients) can reach their highest potential. Our entire workflow cultivates NEWJOBPHORIA® with candidates and employees throughout their engagement with SPECTRAFORCE. http://www.spectraforce.com

We have built our business by providing talent and project-based solutions, including Contingent, Permanent, and Statement of Work (SOW) services to over 130 clients in the US, Canada, Puerto Rico, Costa Rica, and India. Key industries that we service include Technology, Financial Services, Life Sciences, Healthcare, Telecom, Retail, Utilities and Transportation.

Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at [email protected] if you require reasonable accommodation.