AlbuquerqueRecruiter Since 2001
the smart solution for Albuquerque jobs

Member Care Coordinator

Company: Computer Resource Solutions
Location: Albuquerque
Posted on: February 15, 2020

Job Description:

Overview: The CRS Group is currently looking for a Member Care Coordinator for one of our clients in the Albuquerque area. The CRS Group is a nationwide Staffing Firm who works primarily with Fortune 500 and Fortune 1000 corporations.Duration: 6 month contractLocation: Albuquerque, NM 87109Job Description:This position is responsible for conducting home health assessment, contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities.Responsible for home health assessments and system updatesPerform outreach and follow up attempts to members on their health care plan.Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise.Inform and educate members on their program, may use supplied scripts. Complete records in system by performing data entry.Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation).Generate appropriate correspondence and send to member manually, electronically, or telephonicallyConduct check-ins with members to review individual care plan goals.Maintain production requirements based on established department business needs.Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate, manage, and close a case within the platform.Receive, analyze, conduct research and respond to telephone and/or written inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customer or send to appropriate internal party.Notify help desk of system issues.Perform data entry function to update customer or provider information.Obtain required or missing information via correspondence or telephone.May serve as contact for the various groups regarding claims which involves conducting research, obtaining medical records/letters of medical necessity from TMG, reopen or initiate new cases as needed and refer case to clinicians.Support and maintain communications with various in-house areas regarding groups' concerns, i.e.: Marketing, Provider Affairs, and SSD.Communicate and interact effectively and professionally with co-workers, management, customers, etc.Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.Maintain complete confidentiality of company business.Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested. Qualifications:Bachelor of Social Work or Psychology OR LVN, LPN with 1-year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.Knowledge of medical terminologyExperience coordinating member medical related needs, providing assistance to members, and analyzing member needsPC proficiency including Microsoft Office applicationsCustomer service skillsVerbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issuesCurrent state driver license, transportation, and applicable insuranceAbility and willingness to travel crs_scapozzicrs_apoethkow ss # 85834 Qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or genetic information.

Keywords: Computer Resource Solutions, Albuquerque , Member Care Coordinator, Other , Albuquerque, New Mexico

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Emergency Department - ED/ER RN - Travel (Albuquerque)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Medical Surgical - Med/Surg RN - Travel (Albuquerque)
Description: Registered Nurse.
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Labor & Delivery - L&D RN - Travel (Albuquerque)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020


Surgery - OR / CVOR RN - Travel (Albuquerque)
Description: Registered Nurse.
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Pre/Post Anesthesia Care - PACU - RN - Travel (Albuquerque)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Burn Unit - ICU - RN - Travel (Albuquerque)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Medical Intensive Care Unit MICU RN - Travel (Albuquerque)
Description: Registered Nurse.
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Progressive Care Unit - PCU- Travel (Albuquerque)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Cardiac Cath Lab - RN - Travel (Albuquerque)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Neonatal Intensive Care Unit - NICU RN - Travel (Albuquerque)
Description: Registered Nurse. Travel
Company: HealthCare Traveler Jobs
Location: Albuquerque
Posted on: 02/24/2020

Log In or Create An Account

Get the latest New Mexico jobs by following @recnetNM on Twitter!

Albuquerque RSS job feeds