What are the responsibilities and job description for the Care Management Management | MLTC position at Integrated Resources, Inc?
Title: Care Management Management | MLTC
Location: New York, NY 10004
Duration: 3 months with very high possibility of extension
Shift Time: 9am to 5pm 2 days onsite 3 days remote
Pay: $28/hr. - $30/hr. on w2
Summary
Client is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
The Care Management Associate, under the direction of the CMA Supervisor, is responsible for providing coordinator support to members in the MLTC and MAP lines of business. Daily activities include conducting receiving calls as part of the in-bound member call center, managing in-bound requests received by fax, and performing other duties associated with the coordination of member care in collaboration with other staff on the MLTC/MAP Team.
Roles & Responsibilities:
Location: New York, NY 10004
Duration: 3 months with very high possibility of extension
Shift Time: 9am to 5pm 2 days onsite 3 days remote
Pay: $28/hr. - $30/hr. on w2
Summary
Client is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
The Care Management Associate, under the direction of the CMA Supervisor, is responsible for providing coordinator support to members in the MLTC and MAP lines of business. Daily activities include conducting receiving calls as part of the in-bound member call center, managing in-bound requests received by fax, and performing other duties associated with the coordination of member care in collaboration with other staff on the MLTC/MAP Team.
Roles & Responsibilities:
- Completes missing information from documentation received.
- Confirms conflicting information accuracy in the documentation
- Handles incoming calls on the MLTC and MAP ACD phone line and places inbound calls as necessary.
- Maintains files on members and tracks status of membership.
- Serves as liaison between and HHA/PCS/CDPAS vendors regarding member benefits.
- Enters prior approvals into systems.
- Uses system to enter authorization or services as per benefit of the program.
- Notifies vendors of the start date of the services for members.
- Tracks and monitors key information identified by the team lead of MLTC for quality purposes.
- Tracks and monitors members’ admissions to hospitals, nursing home facilities, ER visits and unexpected outcomes
- Tracks member’s short-term absence from geographic areas.
- Reports common trends identified during member contact
- Notifies Care Manager if a member cannot be contacted.
- All other tasks assigned by the Team Lead or the management team.
- High School graduation or evidence of having satisfactory passed a High School Equivalency Program
- One year of satisfactory full-time experience in direct consumer contact.
- Understanding of Medical terminology preferred.
- Knowledge of ICD-10 and CPT-4 codes preferred.
- Prior managed care experience preferred.
- Prior experience customer services/call center experience required.
Salary : $28 - $30