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.

Right to Hire - Patient/Member Services

$20/hr

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