• Job Description

  Req#: 25-77067
  
  Position Purpose:
  Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.
  
  Education/Experience:
  Requires a High School diploma or GED
  Requires 1 – 2 years of related experience
  
  
  
  License/Certification:
  
  For Florida-Sunshine Health Plan - All interactions with members are done telephonically.
  For Arkansas Total Care plan - This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required" "Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
  
  Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
  
  Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
  
  Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
  
  May support performing service assessments/screenings for members and documenting the member’s care needs
  
  Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
  
  Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
  
  Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
  
  Provide education on benefits and resources available
  Performs other duties as assigned.
  
  Complies with all policies and standards.
  
  EEO:
  
  “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
  
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  What is the purpose of this team? Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?	This position will be part of the Show Me Health Kids Care Management team, we serve all of Missouri’s foster care members, individauls who are adopted and have a subsidy, as well as individuals committed to the Division of Youth Services. The primary responsibility for this role is to research, request, gather, and document medical records of new members entering into the foster care system. The individual will also assist as needed. This request is temporary as additional staff will be hired within the next year to support this need.
  Typical Day in the Role
  Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?	CC II will research systems to locate medical history, outreach providers to request records, retrieve the records once they are sent and upload into shared systems. All steps are documented and reported to external partners. NOT ENGAGING WITH THE MEMBERS. Mainly just documentation. The expectation is to track process for each member assigned, up to 20 members per day. Faxes, emails and calls to providers will be required to gather necessary information. No member outreach. The individual will need to be a self-starter, independent work, utilize critical thinking, follow work processes and ensure appropriate documentation . Truly helping our foster care members obtain the medical care needed.
  Candidate Requirements
  Education/Certification	Required: High School Diploma	Preferred: NA
  Licensure	Required: NA	Preferred:NA
  Years of experience required: Minimum of 2 years of health provider office/hospital setting, administrative experience, working within multiple systems at once and converting files. Disqualifiers: No administrative experience, no access to dependable internet services, no access to private HIPAA compliant work space. Not only call center experience, must have more. Must be ok with independent work, won’t be communicating with members. Additional qualities to look for: Medical records experience Service minded Provides strong customer services and represents healthplan well with outreaches (Quality metrics-evaluation and audited for quality of documentation and calls) at least 20 members per day.
  Top 3 must-have hard skills stack-ranked by importance	1	Dependable, critical thinking, independent worker, self starter
  2	Strong Organizational Skills, attention to detail, accuracy, ability to follow workflow with multiple moving parts
  3	Strong Documentation Skills
  
  

• About the company

  Mindlance is one of the largest diversity-owned staffing firms in the US . As a recruitment centric talent acquisition company, Mindlance provides Technology, Engineering, Digital / Creative / Marketing, Clinical Research, Scientific, Finance, Professional and Payroll Management staffing services to Global 1000 companies across the US, Canada and India.

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