Care Management Support Coordinator IV – Team Lead

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

📋 Description

• Oversee the care management team in administrative activities related to care management, which includes outreach, inbound communications, and scheduling services.

• Act as a liaison for members, providers, and staff to address questions related to care plans and maintain accurate member records.

• Conduct member outreach via phone to facilitate care plan next steps, provide information on community or health plan resources, address scheduling inquiries, and deliver ongoing education.

• Assist members in connecting with health plan and community resources.

• Utilize advanced knowledge of health plan activities and available resources.

• Offer frontline support for intricate member and provider inquiries, requests, and concerns.

• Identify opportunities for process enhancements and make appropriate recommendations.

• Leverage advanced understanding of care management support activities, care plans, and community resources.

• Carry out onboarding for new team members and manage daily administrative tasks, which include preparing welcome letters, correspondence, and educational materials.

• Forward highly complex requests and inquiries to management for resolution.

• Document and uphold non-clinical member records in compliance with state and regulatory requirements.

• Contribute to the development of education and training programs.

• Execute other assigned responsibilities while adhering to organizational policies and standards.

⛳️ Requirements

• High School diploma or GED is required.

• A minimum of 4 years of related experience is necessary.

• Completion of a Texas DFPS background check is mandatory.

• At least 2 years of care coordination experience with diverse populations, including children, adolescents, adults, and seniors.

• Familiarity with, or a working understanding of, PSON and MNSF workflow processes is preferred.

• A minimum of 2 years of experience with STAR Health, STAR Kids, STAR+PLUS, Duals, Medicaid, and/or Medicare programs is required.

• Strong documentation skills with proven audit performance in TruCare Cloud.

• Demonstrated professionalism, diplomacy, adaptability, and meticulous attention to detail in a fast-paced environment.

• Proficiency in Microsoft Office Suite, including Excel, OneNote, PowerPoint, and Outlook.

• Excellent abilities in problem-solving, organization, time management, and communication.

• Capability to swiftly adapt to changing business priorities while maintaining flexibility and professionalism.

• Ability to articulate data, findings, and recommendations clearly to cross-functional stakeholders.

🏝️ Benefits

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement assistance.

• Paid time off along with holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional incentives may be included in total compensation.

• Equal opportunity employer dedicated to promoting diversity.