Description: Will this role be fully remote?: Yes
Are there any specific locations the candidates should be in (i.e., do they need to live in IL): Texas
What is the expected schedule (include dates/time/timezone): M-F 8am-5pm CST (1 hour lunch)
Minimum requirements: HS Diploma or GED & 1-3 years experience in an administrative role in healthcare
What additional IT equipment is required outside of a laptop/headset/mouse/keyboard (i.e., dual monitor & docking station or single monitor & connecting cables – note these will be billed back to Client at cost): dual monitors and docking station.
Is there potential for this to extend past 6 months and/or convert to an FTE? Set to end 09/15/2027 – there is not an expectation to convert to a FTE

Duties and Responsibilities (List all essential duties and responsibilities in order of importance)
Provides support to the Case Management staff performing non clinical activities and supporting the management
of the department.
Responsible for initial review and triage of Case Management tasks.
Reviews data to identify principle member needs and works under the direction of the Case Manager to implement
care plan.
Screens members using Client policies and processes assisting clinical Case Management staff as they identify
appropriate medical services
Coordinates required services in accordance with member benefit plan.
Promotes communication, both internally and externally to enhance effectiveness of case management services
(e.g., health care providers and health care team members).
Runs reports to assist in coordination of case management needs.
Provides support services to case management team members by answering telephone calls, taking messages
and researching information.
Maintains accurate and complete documentation of required information that meets risk management, regulatory,
and accreditation requirements.
Protects the confidentiality of member information and adheres to company
Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job
satisfactorily)
Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity
to concerns, proactive identification and resolution of issues to promote positive outcomes for members
Demonstrated ability to communicate, problem solve, and work effectively with people
Working knowledge of medical terminology and abbreviations
Ability to think analytically and to problem solve.
Good interpersonal/team skills
Must have a high regard for confidential information
Ability to work in a fast paced environment
Able to work independently and as part of a team.
PC experience in Windows environment and accurate data entry at 40 WPM minimum.
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members,
providers and customers

Required Education:
High School Diploma or G.E.D.

Required Experience:
Two or more years experience as a medical assistant,
office assistant or other healthcare service administrative
support role.

Custom Fields:
Name: Requires Network Access
Value: Yes without equipment

Name: RBAC Job Function
Value: {items=[{itemValueId=23a8d184-c03c-47a2-b8d2-83bf7e4f3ff2, itemValue=Customer Experience Rep Service Fulfillment}]}

Name: Healthplan by State
Value: {items=[{itemValueId=0e4bb365-0476-49f4-b43d-c09e94135cc3, itemValue=*** of Texas, Inc.}]}

Name: Business Service Lines ShuffleBox
Value: {items=[{itemValueId=3c3b5c78-639e-4a39-a103-05ffceaba5e1, itemValue=MMP}, {itemValueId=d7bed363-f6ca-480d-8fcb-19f063718538, itemValue=DSNP}, {itemValueId=f53eb882-9b41-457b-8365-27dc82f5d9c8, itemValue=Medicare}, {itemValueId=b92ffb01-a79d-4453-b8aa-b127c9458658, itemValue=Medicaid}]}

Name: Will worker have access to Client PHI?
Value: Yes