Case Management Coordinator (Spanish & English speaker) Solis Health Plans - 2.8 Doral, FL Job Details Full-time $20 an hour 1 day ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Employee discount Life insurance Referral program Retirement plan Qualifications Computer operation Spanish Interpersonal skills HIPAA English High school diploma or GED Attention to detail Organizational skills Productivity software Medical terminology Full Job Description

POSITION SUMMARY

•Bilingual in English & Spanish

•Case Management Care Coordinators are instrumental in helping members manage their health by serving as a liaison between the health plan's Case Management Department and the member's health care providers. Case Management Care Coordinators perform their duties as an extension of the case management team to ensure components identified as part of the member's care are addressed and arranged. The Case Management Care Coordinator provides support by outreaching to members and ensuring their needs are met. In addition, the Case Management Care Coordinator will gather key elements of information that will allow others within the department as well as other departments to provide exceptional customer care through attention to detail, attentive and empathetic communication, and follow-up that may be needed for optimal healthcare experiences. This requires a flexible attitude, quick thinking, and a caring disposition. Day-to-day activities may vary based on member needs and departmental requirements, but can involve the following tasks and responsibilities: This position works fully onsite Monday- Friday.

ESSENTIAL DUTIES & RESPONSIBILITIES

Performs member screening through health risk assessment completion. Completes interventions as determined by member's individualized care plan. Schedules appointments in support of care plan goals. Ability to professionally communicate with nurses and physicians both internal and external to organization. Handles inbound calls and answers member questions. Connects with members via phone as well as alternate communication methods. Is familiar and coordinates with community resources that will support interventions on member's individualized care plan. Ability to document within the member's electronic record. Assist the case management team with support and follow-up of interventions and actions. Ensures compliance with all regulatory requirements inclusive of HIPAA, OSHA, and other federal, state, and local regulations. Helps with data collection. Maintains a polite and professional demeanor at all times. Maintains patient confidentiality at all times. Must be able to work within a high-paced and demanding environment. Must be able to multi-task and prioritize appropriately. Assists with training of new staff members. Must be able to multi-task and prioritize appropriately. Assists with training of new staff members. Performs other duties and projects as assigned.

QUALIFICATIONS & EDUCATION

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. High School Diploma and a minimum of two (2) years' experience in a healthcare related customer service position; or equivalent combination of education and experience. Insurance experience in the Medicare and managed care field is preferred. Knowledge of CMS guidelines is preferred. Excellent computer knowledge is required, including proficient knowledge of Microsoft Office. Strong decision-making and organizational skills. Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization. Must be able to perform duties with little supervision. Willingness and ability to function independently and as a team member. Working Knowledge of medical terminology. Fluency in English and Spanish required.

PERFORMANCE MEASUREMENTS

Compliance with Department Call Metrics/ Company Regulations. Attendance/Punctuality. Adherence to company and departmental policies and procedures. Quality of work. Quantity of work. Safety and Security.

WHAT SET US APART

Join Solis Health Plans as a Case Management Care Coordinator and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference! This Job Description may be modified at any time at the discretion of the employer as business operations may deem necessary. This does not constitute an employment agreement and may not include all duties. The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. The incumbent must be able to work in a fast-paced environment with a demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate.

Job Type:

Full-time Pay:

$20.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Employee discount Health insurance Life insurance Paid time off Referral program Retirement plan Vision insurance Ability to

Commute:

Doral, FL 33178 (Required) Ability to

Relocate:

Doral, FL 33178: Relocate before starting work (Required)

Work Location:

In person