Care Management Associate (Remote)

Position Summary

Support comprehensive coordination of medical services, screening and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes, supports quality effectiveness of Healthcare Services, Care Management Associates (CMAs) support the Care Management (CM) team by performing nonclinical, administrative duties. These duties may include but are not limited to processing referrals, making outreach calls, entering data into Dynamo or QNXT, and processing member mailings.

Key Responsibilities

• Effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm.

• Demonstrates ability to meet daily metrics with speed, accuracy, and a positive attitude.

• Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification, and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures).

• Completes documentation of each member call in the electronic record, thoroughly completing required actions with a high level of detail to ensure compliance requirements are met with efficiency.

• Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic, and caring presence telephonically.

• Ability to effectively participate in a multi-disciplinary team including internal and external participants.

Remote Work Expectations

• This is a 100% remote role; candidates must have a dedicated workspace free of interruptions.

• Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Required Qualifications

• Minimum of 1 year of Customer service experience preferably in the healthcare industry.

• Experience with computers including knowledge of Microsoft Word, Outlook, and Excel – data entry and documentation within member records preferred.

• Strong organizational skills, including effective verbal and written communication skills.

Preferred Qualifications

• 2-4 years’ experience in healthcare field (i.e. experienced in medical office, hospital setting, medical billing/coding) preferred.

• Familiarity with basic medical terminology and concepts used in care management preferred.

• Flexibility to work occasional outside of standard business hours.

Education

• High School Diploma or G.E.D. required.