• Job Description

  Req#: 25-59675
  Job Description: Position Purpose:
  Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.
  
  Education/Experience:
  Requires a High School diploma or GED
  Requires 1 – 2 years of related experienceProvides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service
  
  Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
  
  May apply working knowledge of assigned health plan(s) activities and resources
  
  Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols
  
  Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
  
  Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
  
  Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs
  Performs other duties as assigned
  
  Complies with all policies and standards
  Comments for Vendors:
  
  EEO:
  
  “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
  
  ============

  Centene Job Description
  "Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service May apply working knowledge of assigned health plan(s) activities and resources Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs Performs other duties as assigned Complies with all policies and standards"
  Story Behind the Need – Business Group & Key Projects
  Health plan or business unit Team culture Surrounding team & key projects Purpose of this team Reason for the request Motivators for this need Any additional upcoming hiring needs?	Supervisor led environment, weekly meeting and morning huddles Individual will be contacting member telephonically – like working in a call center – making outbound calls and receiving inbound call
  Typical Day in the Role
  Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description	Contractors have inbound que and have outbound call Complete emails, production information for the day is given through They will be able to reach out to the supervisor for assistance Remote work
  Compelling Story & Candidate Value Proposition
  What makes this role interesting? Points about team culture Competitive market comparison Unique selling points Value added or experience gained
  Candidate Requirements
  Education/Certification	Required: i.e. High School diploma, GED.	Preferred:
  Licensure	Required:	Preferred:
  Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: Nice to haves:, Bilingual Disqualifiers: Performance indicators: Individuals are expected to Contact minimum of 28 members daily maintain audit score of 95% on a monthly bases
  Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	1 year healthcare experience
  2	Call Center experience
  3
  Candidate Review & Selection
  Shortlisting process Second touchpoint for feedback Interview Information Onboard Process and Expectations	Projected HM Candidate Review Date:	4/15
  Number and Type of Interviews:	1
  Extra Interview Prep for Candidate:
  Required Testing or Assessment (by Vendor):	N/A
  Manager Communication Preferences & Next Steps
  Background Check Requirements (List DFPS or other specialty checks here)	No
  Do you have any upcoming PTO?	N/A
  Colleagues to cc/delegate	Herby

• 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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