The Care Management Representative is responsible for providing foundational care management services to support members. This position is within the Care Management Call Center and reports to a Team Lead.
• Receive Incoming calls from members regarding: o Benefit questions/issues, o Care management referrals/inquiries, connecting to their care manager, and screening tools to identify risk factors requiring care management intervention o Inquiries about programs, o Provision of educational materials, o Confirmation and documentation of Members demographic information and o Documents calls in designated CM system. • Works with the interdisciplinary care team to support timely communication of member issues or needs. • Receives referrals from right fax and within the interdisciplinary care team and data enters into Clinical System. • Performs outreach calls to members to members to perform screenings for eligibility of Care Management • Performs outreach calls to members for High Risk Surveys (may be short term) • 100% of time assigned to call center. • Perform other duties as assigned Minimum Qualifications: • High school diploma or GED Preferred Qualifications: • Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department. • Demonstrated ability to document calls into a computer system. • Excellent telephone, customer service, oral and written communication skills. • Team player who is organized and detail-oriented. • Knowledge of medical terminology. • Experience with screening or triage of patients such as in a physician's office, clinic, hospital, care management or long-term care.
Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $65,600 - $94,775 All Other Locations (within approved locations): $58,300 - $86,700 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.