Care Coordinator

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Act as a clinical resource for members seeking advice on screenings and other preventive measures to enhance overall health for themselves and their families.

• Offer clinical assistance to the Support team by managing live member calls, emails, and chats for those in need of clinical support while using the program.

• Lead the internal examination of client plan documents, creating benefit coverage summaries for the Provider Relations and Support team to address members’ inquiries.

• Provide documentation of coverage that outlines specific protocols for various specialties such as physical therapy, chiropractic visits, oncology, and bariatric procedures.

• Serve as a clinical liaison for providers with questions about clinical coverage, treatment options, second opinions, and alternative treatment plans.

• Follow up on pending matters, ensuring that members receive timely and responsive updates.

• Comply with documentation standards to guarantee that all provider and member support inquiries are accurately recorded for client evaluations, analytical assessments, and legal requirements.

• Initiate and manage the development of infographics and other marketing materials for important healthcare awareness months such as Breast Cancer Awareness, Colon Cancer Awareness, Diabetes Education, and Menopause.

• Actively contribute ideas on how to market to or better serve our member base.

• Attain proficiency in the client’s program knowledge to deliver the highest quality of support and service to members.

• Engage in special projects identified by management or suggested by staff, collaborating with management on project priorities as necessary.

• Carry out other miscellaneous office duties as required.

⛳️ Requirements

• Demonstrated experience as a Care Coordinator, Case Manager, or in a similar role within a healthcare environment.

• Strong clinical background with an understanding of preventive healthcare measures and treatment options.

• Exceptional communication abilities, both written and verbal.

• Competence in managing member and provider inquiries through phone, email, and chat.

• Excellent organizational skills and meticulous attention to detail.

• Capability to work independently in a remote setting.

• Familiarity with healthcare documentation standards and legal obligations.

• **Preferred Qualifications**

• Bachelor’s degree in Nursing, Health Administration, or a related discipline.

• Experience with healthcare plan documentation and benefit coverage.

• Knowledge of creating educational and marketing materials for healthcare awareness initiatives.

• HIPAA Certification or training.

• USRN Certificate.

• Active NCLEX license.

🏝️ Benefits

• Join Our Dynamic Team: Experience our fun, inclusive, innovative culture that values your unique contributions and supports your professional growth.

• Embrace the Opportunities: Seize daily chances to learn, innovate, and excel. Make a real impact in your field.

• Limitless Career Growth: Unlock a world of possibilities and resources to propel your career forward.

• Fast-Paced Thrills: Thrive in a high-energy, engaging atmosphere. Embrace challenges and reap stimulating rewards.

• Flexibility, Your Way: Embrace the freedom to work from home or any location of your choice. Create your ideal work environment.

• Work-Life Balance at Its Best: Say goodbye to stressful commutes and hello to quality time with loved ones. Achieve a healthy work-life integration to perform at your best.