Care Management Support Specialist

Profile

Description

Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state. CMSS do this by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Support Specialist performs varied activities and moderately complex administrative/operational/customer support assignments and typically works on semi-routine assignments. CMSS's work collaboratively with clinical support associates, (including nurses and social workers,) as well as with each other - as part of an interdisciplinary team.

Responsibilities

The Support Specialist daily assignments are focused on adherence to area/department policies and methods. The CMSS works within defined parameters to identify work expectations and quality standards in an area with frequently changing prioritization and timing. This role requires the ability to successfully work within outlined expectations, and within specific standards. Working hours for this position is an 8-hour shift, bases on business needs, between 9:30AM and 8PM Eastern Standard Time Mon-Fri. This role requires occasional mandatory overtime, which may include weekend hours.

In this production-based role, you will:

Have a production-based quota

Work with customers (members), business partners, and clinical partners

Provide support for various lines of business

Handle a combination of inbound and outbound calls

Help route calls between departments, and teams

Help provide members with educational resources

Act as a point person on non-clinical issues

Research and verify resources and/or referrals

Assist with message/email routing to appropriate area, including shared e-mail boxes

Schedule and support care conferences

Utilize multiple applications/software throughout your day

Assist with member assignment/routing

Assist with other tasks as needed

Successful candidates thrive in a collaborative team-based environment and values the unique perspectives of others

Leverage clinical experience and expertise, as well as flexibility and openness, in new ways of working

Be a part of an exciting and frequently changing environment

Required Qualifications

1- 3 years of healthcare administration or call center experience

Able to work in a fast paced, multitask work environment

Knowledge of Microsoft Word, Excel, and Outlook

Experience meeting productivity metrics in a high-volume production-based work environment

Excellent communication and interpersonal skills

Access to a private/undisrupted work at home office space

Access to high-speed internet

Ability to work independently in a home office setting

Preferred Qualifications

Associate degree

3 years technical experience

sales and/or customer service experience

Administration support experience in the healthcare industry

Bilingual in English and Spanish

Office 365 and Cloud based services

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com