Overview
On Site
Depends on Experience
Contract - W2
Job Details
Member Care Coordinator | 3+ Years of Experience | Remote/Fieldwork in Santa Fe/Taos, NM | Contract to Hire
Walker Healthforce is seeking a Member Care Coordinator with 3+ Years of Experience to support a Healthcare Payor Client based in Santa Fe/Taos, NM. This is a 6 month contract to hire opportunity.
MUST BE LOCAL TO: Santa Fe/Taos, NM
START DATE: ASAP
HOURS/SCHEDULE: M-F 8am-5pm
WORKER TYPE: W-2
CORE REQUIREMENTS:
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND1
Walker Healthforce is seeking a Member Care Coordinator with 3+ Years of Experience to support a Healthcare Payor Client based in Santa Fe/Taos, NM. This is a 6 month contract to hire opportunity.
MUST BE LOCAL TO: Santa Fe/Taos, NM
START DATE: ASAP
HOURS/SCHEDULE: M-F 8am-5pm
WORKER TYPE: W-2
CORE REQUIREMENTS:
- 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.
- Knowledge of medical terminology.
- Experience coordinating member medical-related needs, providing assistance to members, and analyzing member needs.
- PC proficiency including Microsoft Office applications.
- Written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues.
- Current state driver license, transportation, and applicable insurance.
- Ability and willingness to travel.
- Conduct home health assessments.
- Contact identified members to inform and educate them on health care programs to address their personal health plan needs.
- Engage members in discussions of adherence to personal health plans.
- Respond to inquiries from members.
- Support clinicians in the Medical Management department with provider and member activities.
- Responsible for home health assessments and system updates.
- Perform outreach and follow-up attempts to members on their health care plan.
- Build relationships with members to encourage compliance with care plans and alert the Case Manager quickly when issues arise.
- Inform and educate members on their program, using supplied scripts as needed. Complete records in the system by performing data entry. Encourage member usage of programs, including arranging appointments and additional member services (e.g., transportation). Generate appropriate correspondence and send to members manually, electronically, or telephonically.
- Conduct check-ins with members to review individual care plan goals.
- Maintain production requirements based on established department business needs.
- 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.
- Receive, analyze, conduct research, and respond to telephone and/or written inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customers or send to appropriate internal party.
- Notify help desk of system issues.
- Perform data entry function to update customer or provider information.
- Obtain required or missing information via correspondence or telephone.
- Serve as contact for various groups regarding claims, which involves conducting research, obtaining medical records/letters of medical necessity from TMG, reopening or initiating new cases as needed, and referring cases to clinicians.
- Support and maintain communications with various in-house areas regarding groups’ concerns (e.g., Marketing, Provider Affairs, and SSD).
- Communicate and interact effectively and professionally with co-workers, management, and customers.
- Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
- Maintain complete confidentiality of company business.
- Maintain communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.
- Competitive compensation package
- Weekly pay via Direct Deposit
- Medical, Dental & Vision available
- 401k options
- Access to our top ranked team of recruiting and placement specialists
- Continuous, one-on-one support from a dedicated engagement manager
- Professional resume development and interview preparation
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND1
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