The selected candidate will manage 40 to 60 outbound calls.
These outbound calls are initial calls or follow ups calls for scheduling.
The selected candidate will also enter authorizations answer send emails to providers.
To be successful the candidate must have excellent customer service and communication skills, be able to work independently, comfortable with outlook and excel
Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.
Trouble shoots for the clinical team when an appropriate provider, type of service, or appropriate level of care cannot be readily found.
Researches availability of community services in order to link members to appropriate services. Assists in transitions in care for hospitalized patients and makes appropriate placements as needed.
Assumes responsibility for self-development and career progression.
Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role.
Remains responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
Coordinates and manages distribution of correspondence and materials to enrollees and providers.
Participates in operational activities, including data collection, tracking, and analysis.