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- Reach out and follow up with members regarding their healthcare plans.
- Establish relationships with members to promote adherence to care plans and promptly escalate issues to the Case Manager when necessary.
- Educate and inform members about their program, potentially utilizing provided scripts. Input data and maintain records in the system. Encourage members to engage with our programs, such as scheduling appointments and accessing additional services (e.g., transportation). Prepare and send relevant communications to members manually, electronically, or via phone.
- Regularly check in with members to review their care plan objectives.
- Meet productivity targets based on departmental requirements.
- Support the clinical team by handling non-clinical tasks (as defined by the business process) essential for initiating, managing, and closing cases within the platform.
- Receive, analyze, research, and respond to phone or written inquiries. Evaluate information from members or providers to identify needs and ensure queries are addressed. Provide responses or direct inquiries to the appropriate internal department.
- Report system problems to the help desk.
- Update member or provider information through data entry.
- Collect necessary information through written correspondence or phone communication.
- Act as a liaison for different groups regarding claims, which may involve investigating, obtaining medical records, reopening or initiating cases when needed, and referring cases to clinicians.
- Collaborate and maintain communication with internal departments, including Marketing, Provider Affairs, and SSD.
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LVN-Member Care Coordinator-Pediatric - Waco, United States - HireOps Staffing LLC
Description
We are looking for candidates in or around McClennan County
This position allows remote work with occasional field visits.
**Job Title: Pediatric Care Coordinator**
**Company: Health Care Services Inc.**
**Must have Pediatric Experience**
**Hourly Rate:** $40/hr
This role involves conducting home health assessments, reaching out to members to provide them with information on healthcare programs tailored to meet their individual health needs, engaging members in conversations about following their personalized healthcare plans, addressing member inquiries, and supporting clinicians in the Medical Management department with member and provider activities.
ESSENTIAL FUNCTIONS:
LOGISTICS:
LVN with a minimum of 1 year experience in managed care systems, pediatrics, case management, or home health.
Proficiency in medical terminology
Experience in organizing member medical needs, supporting members, and assessing member requirements
Proficient in PC usage, including Microsoft Office tools
Strong customer service skills
Excellent verbal and written communication skills, including the capacity to draft written messages to members and other teams, as well as coaching skills for educating members on medical matters
Possession of a current state driver's license, reliable transportation, and appropriate insurance coverage
Willingness and ability to travel when required
