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Healthfirst

UM Support Coordinator - 100%

Remote

Description and Requirements

The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) and may have additional departmental responsibilities.

Duties and Responsibilities:

  • Provides excellent quality customer service to our members and/or providers relating to questions/issues such as coordinating care, DME outreach, scheduling appointments, and screen assessments to identify risk factors which need closer intervention
  • Handles calls to and from providers regarding authorizations, referrals, visits, tests, and faxed care plans
  • Escalates calls to appropriate departments which may include but is not limited to inbound/outbound calls on behalf of Case Managers
  • Manages a large member caseload
  • Meets/Exceeds all performance KPIs including but not limited to quality and productivity
  • Builds sustainable relationships of trust through open and interactive communication with internal and external customers
  • Documents accurate member information in compliance with our internal procedures
  • Follows established policies and procedures to ensure member and provider issues are addressed timely and accurately
  • Timely communicates member issues or needs and monitors screening of members effectively to improve quality and cost outcomes
  • Complies with HIPAA requirements and maintains Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information, and adheres to local, state, federal and Healthfirst specific compliance and regulatory guidelines
  • Additional duties as assigned

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Minimum Qualifications:

  • High School diploma or GED from an accredited institution
  • Prior experience in a customer service environment
  • Working experience in a fast-paced environment
  • Proficient in Microsoft Office Suite applications including Excel, Word, and Outlook

Preferred Qualifications:

  • Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese.
  • Knowledge of medical terminology
  • Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department
  • Experience navigating multiple technologies including a Customer Relationship Management System (i.e., locate information, route future actions, notate resolutions, update member information, etc.)
  • Proven track record of exercising independent thinking, problem solving and achieving goals
  • Excellent verbal and written communication and the ability to document grammatically correct emails, communications, and presentations

Hiring Range:

  • Greater New York City Area (NY, NJ, CT residents): $39,208 - $52,000
  • All Other Locations (within approved locations): $34,091 - $49,920

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Job ID: healthfirst-R018418
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Health Reimbursement Account
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
    • HSA
    • Fitness Subsidies
    • Mental Health Benefits
    • Pet Insurance
  • Parental Benefits

    • Birth Parent or Maternity Leave
    • Family Support Resources
  • Work Flexibility

    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Office Life and Perks

    • Commuter Benefits Program
    • Casual Dress
    • Happy Hours
    • Company Outings
    • Holiday Events
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
    • Volunteer Time Off
  • Financial and Retirement

    • 401(K) With Company Matching
    • Performance Bonus
  • Professional Development

    • Internship Program
    • Tuition Reimbursement
    • Promote From Within
    • Access to Online Courses
    • Lunch and Learns
    • Associate or Rotational Training Program
    • Learning and Development Stipend
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Woman founded/led
    • Diversity, Equity, and Inclusion Program

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