Dedicate 50-75% of the day to engaging with members and coordinating their care
Utilize all available resources to connect with and engage “hard-to-reach” members
Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs
Maintain meticulous documentation of care management activities in the member’s electronic health record
Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition
Identify and connect members with health plan benefits and community resources
Meet regulatory requirements within specified timelines
Collaborate and leverage the Care Manager RN clinical expertise to ensure members’ needs are adequately addressed

2+ years of experience in a health-related field
2+ years of customer service experience
Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams)
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position
Experience providing care management for Medicare and/or Medicaid members (preferred)
Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health (preferred)
Experience conducting health-related assessments and facilitating the care planning processes (preferred)
Bilingual skills, especially English-Spanish (preferred)
Associate’s degree with relevant experience in a health care-related field or Practical Nurse degree/certificate with active state licensure.

Analyst, Care Management Specialist

About this role