Care Management Specialist
Core
Telephonic Care Manager Specialist coordinating care for Special Needs Plan members with social determinants of health needs and stable health conditions.
Role type
Senior IC care management specialist (telephonic)
Builds
Individualized care plans and preventative health maintenance strategies for Medicare/Medicaid members
Domain
US Healthcare (Medicare/Medicaid Managed Care)
Deliverable
production ML models | product features | dashboards & analysis | client delivery | physical/clinical work
Required skills
Care management knowledge, community resource identification, health risk assessment, care planning, regulatory compliance, Microsoft Office proficiency, telephonic engagement
Preferred skills
Medicare/Medicaid member experience, SDoH/chronic condition/behavioral health experience, health assessment facilitation, bilingual (English-Spanish)
Technologies
Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams), Electronic Health Record systems
Responsibilities
Conduct telephonic engagement with members to coordinate care, develop individualized care plans, maintain documentation in electronic health records, connect members with community resources, consult with Registered Nurses for clinical decision support, meet performance metrics and regulatory timelines
Seniority
Mid-level, hands-on IC