Care Management Support Assistant

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

📋 Description

• Manage referrals from Military Treatment Facilities and civilian providers for the Autism Care Demonstration program.

• Identify ACD-specific assessments and treatment plans.

• Pend referrals and authorizations for evaluation.

• Collaborate with Autism Services Navigators and Utilization Management to coordinate authorizations.

• Address inquiries from associates and MTF/civilian providers and gather additional information to finalize referrals.

• Enter data into the medical management system.

• Conduct eligibility assessments and review ECHO benefits.

• Complete non-clinical summaries of assessments.

• Document and pend tasks to the relevant queues for completion or requests for more information.

• Handle incoming TRICARE Autism Care Demonstration calls using available resources.

• Provide education to beneficiaries and providers regarding the TRICARE ACD program.

• Monitor phone queues and web chats for inquiries from providers and beneficiaries.

• Report to a Supervisor of Care Management Support.

⛳️ Requirements

• Availability to work a shift from 10:30 a.m. to 7 p.m. E.T.

• Minimum of 2 years of experience in medical coding and/or behavioral health.

• At least 3 years of experience in customer service or referral management, managing a high volume of work within deadlines.

• 3 years of experience in the healthcare, medical, or health insurance sector.

• U.S. citizenship is required.

• Must successfully obtain approval for government security clearance through National Background Investigation Services (NBIS).

• Current residency outside of Puerto Rico is required.

• Capability to work Monday through Friday, 10:30 a.m.–7 p.m. EST.

• Willingness to participate in mandatory training hours from 8 a.m.–4:30 p.m. EST for the first 4–6 weeks.

• Reliable home internet connection with a minimum of 25 Mbps download and 10 Mbps upload speed.

• Dedicated workspace free from interruptions to safeguard member PHI/HIPAA information.

🏝️ Benefits

• Comprehensive medical, dental, and vision insurance.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Support for personal wellness.

• Assistance with smart healthcare decisions.

• Occasional travel to Humana offices for training or meetings.