Job Description

Title:  Case Management Coordinator
Location:  Remote, but must reside in PA

This job is responsible for serving as a liaison between the member, the Health Plan, and the provider for the Medicaid and Medicare product. The position conducts telephonic support to assess member needs, provide appointment scheduling assistance, educate members of their rights and responsibilities, and conduct a series of questionnaires to obtains and provide benefit information. This position is also responsible for assisting members in navigating the grievance and appeals process and representing member interests internally and externally.

Responsibilities:

Primary : Supporting our case managers by processing referrals, cases, building referrals, managing faxes, other admin duties as assigned-must be local in PA

Also:

• Initiate outreach efforts, primarily by telephone, related to targeted preventive health initiatives 
• Assess opportunity for Care Management intervention and make appropriate referral 
• Contact members, providers and community agencies to coordinate access to preventive health services
• Tracks all member and provider contacts in the appropriate computer systems for the purposes of data collection and record keeping
• Maintain community repository by validating existing information, adding/deleting resources.

Must have:

• High School Diploma / GED
• A minimum of 2-4 years’ experience in community outreach/customer service
• Good with faxes
• Working with Medicaid members
• Scheduling appointments with members
• Patient charts
• Good written and verbal communication skills
• Knowledge of community based organizations
• Must demonstrate patience and empathy
• This position must be able to utilize sound and flexible productive work habits to set priorities, organize work and utilize time effectively

Nice to have:

• Associates or Bachelor’s Degree
• Prior experience working with members in the Medicaid population