Care Specialist - New York
17 hours ago
Job description
Summary Of JobResponsible for the execution of the non-clinical aspects of the Care Management process.
Ensure information is appropriately entered in the system to effectively execute member care plans, originate authorizations, request clinical information, perform case research, and essentially execute all behind the scenes desk-level procedures of a case.
Work seamlessly with the Care Specialists, Care Managers and Social Workers (and other clinical staff) to ensure everything that a participant needs to tend to their health is addressed.
Provide confidential administrative support and assistance to the department and support the department in all aspects of daily project operations.
Assist the entire Care Management interdisciplinary team in managing members with Care Management needs.Provide telephonic outreach to members that have been identified for care management and ensure members' needs are supported throughout the duration of member enrollment to the program, by completing screenings with members, coordinating with Care Manager on members' care plan, making appropriate referrals to the interdisciplinary care team, coordinating post-acute services on behalf of members, assisting with community resource needs and more.
Principal Accountabilities
Work collaboratively, as a critical component of the Medical Management team, to facilitate all clerical and administrative processes and activities.
Perform accurate and timely intake and data entry for all Care Management requests and referrals for all lines of business, upon receipt of inbound requests, via call, fax and web portal, in accordance with departmental policy and regulatory requirements.
Perform member telephonic outreach for program enrollment with the goal of retaining members in the Care Management Program.Triage cases and assign receipts to appropriate teams.
Communicate and/or respond to inquiries from providers, facilities and members.
Initiate completion of member and provider correspondence and verbal outreach according to departmental guidelines.
Enter and maintain documentation in electronic record, meeting defined timeframes and performance standards.
Provide phone queue management for both incoming and outgoing calls.
Perform other related projects and duties as assigned.
Under the direction of a Care Manager, manage caseload and update care plans for low and moderate risk members in collaboration with the clinical team.
Support care interventions including making doctor's appointments, health coaching, referrals to internal and external resources, assist with transportation issues.Leverage motivational interviewing skills and a member-centric approach to identify members' needs, prioritize and support care plan.
Perform a wide range of research and educational outreach activities to encourage healthy behaviors, such as outreaching to identified members who need a primary care provider or who may have gaps in care related to recommended tests or provider visits and facilitate gap closure and receipt of evidence-based care.
Adhere to processes for collecting member-specific clinical and demographic data from providers and other entities as required by clinical staff.
Support communication and coordination with delegated entities, as necessary.Coordinate directly with community-based organizations and agencies to identify available and/or alternative resources for a wide range of concerns, including home safety, financial assistance, caregiver support and transition assistance.
Actively participate in assigned committees and projects.Additional tasks and duties as required.
Required to work weekends, nights and holiday as necessary.
Qualifications
Bachelor's Degree
Medical Assistant certification preferred
1 – 2+ years of previous client-facing or data entry experience in a health care environment
Additional experience/certifications/training may be considered in lieu of educational requirements
Strong verbal, written and interpersonal communication skills
Ability to work both independently and collaboratively with others
Previous system user experience in a highly electronic environment
Proficiency in MS Office (Word, Excel, Powerpoint, Teams, Outlook, etc.)
Knowledge of medical terminology and medical payment
Ability to prioritize multiple tasks
Ability and willingness to work a flexible schedule including weekends, nights, and holidays as needed
Additional Information
Requisition ID:
Hiring Range:
$39,960-$70,200
Similar jobs
The Care Specialist is responsible for the non-clinical aspects of the Care Management process. They ensure information is entered in the system to effectively execute member care plans and perform various administrative tasks. · Work with Care Specialists, Care Managers, and Soc ...
2 weeks ago
Responsible for the execution of the non-clinical aspects of the Care Management process. Ensure information is appropriately entered in the system to effectively execute member care plans, originate authorizations, request clinical information, perform case research and execute ...
2 weeks ago
Provides technical customer support to ensure that all customers are satisfied with the products and services. · ...
1 week ago
We are looking for a warm, creative, and skilled professional to join our team as a Per Diem Memory Care Specialist. · This role is ideal for a therapeutic recreation specialist or licensed creative arts therapist who is passionate about relationship-centered dementia care. · The ...
1 month ago
We are seeking experienced Newborn Care Specialists (NCS) to support families during the newborn period. · This role is ideal for professionals who value quality care, · professionalism,and working with families who respect expertise. ...
2 days ago
Inspired Memory Care continues to expand its private services division in response to growing demand from families seeking meaningful individualized engagement for loved ones living with cognitive change. · ...
1 month ago
We are seeking a Wound, Ostomy and Continence (WOC) Nurse to join our team at NewYork-Presbyterian Brooklyn Methodist Hospital. · As a WOC nurse, you will be responsible for the delivery of patient care and consultations for patients with wounds and ostomies. · You will work clos ...
1 week ago
We are seeking a Health Care Specialist to provide direct support to individuals with intellectual and developmental disabilities. The ideal candidate will have experience working in a YAI program and hold current AMAP certification. · ...
1 month ago
We are seeking experienced Newborn Care Specialists to support families during the newborn period. · This role is ideal for professionals who value quality care, professionalism, and working with families who respect expertise.Provide expert newborn care (feeding support, soothin ...
1 day ago
We're a friendly couple living on the Upper West Side in NYC seeking two rotational · Newborn Care Specialists for our first baby's arrival · Extensive newborn experience required. · Calm and friendly caregiving style essential. · ...
1 week ago
+ Provide exceptional care to all animals under our supervision · + Ensure an excellent customer experienceClean and disinfect play spaces · Give dogs proper food and water · Take dogs for walks outside the facility · ...
1 week ago
The Client Care Specialist creates joy and ease for all FoundRae clients by delivering seamless, efficient service across every communication channel and touchpoint. This role drives sales performance and cultivates long-term client relationships through expert use of digital and ...
4 weeks ago
Provide exceptional service to customers by telephone, email and chat. · ...
1 month ago
JRN#2417 · A warm, highly private family in New York City is seeking an experienced Rotational Newborn Care Specialist to support them as they welcome their first child. This engagement begins with a 3-month newborn contract with up to 24-hour daily coverage, 7 days on / 7 days o ...
1 hour ago
+We are seeking a Patient Care Specialist / Home Care Personal to join our team. · +Assist with personal hygiene needs and dressing · Assist with mobility, walking, and physical therapy exercises · Prepare meals and snacks · + Previous experience as a caregiver or home health a ...
1 month ago
The Care Transitions Specialist II will coordinate home-based support services to improve hospital-to-home care transitions. The CTS must have capacity to work across home, community and clinical settings. · Conduct in-home assessments with objectives such as identifying home-bas ...
1 week ago
Market Leading Wound Care Company seeks Wound Care Clinician with industry experience and minimum BSN. · A clinical team is being built to call on the Acute Care Setting within the Wound Care and Infection Prevention Departments. · Develop and implement the Clinical Sales Strateg ...
3 days ago
We seek out new ideas and put people first as we push the boundaries of science, make healthcare more accessible, and treat, prevent, and even cure diseases that affect millions of lives. · Ambition to advance broad cardiometabolic disease management by bringing exciting new ther ...
1 month ago
The Cardiometabolic Care Sales Team is at the forefront of US sales efforts for Novo Nordisk's robust cardiometabolic product portfolio. · ...
1 month ago
Join our team at Novo Nordisk where we create value by having a patient-centered approach. · The role will be responsible for achieving sales goals by implementing marketing strategies aimed at effectively selling Novo Nordisk's portfolio of products. · ...
1 month ago