OverviewPosition Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services.
Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.ResponsibilitiesProvide outreach to members via phone to support care plan next steps, community or health plan resources, and questions related to scheduling and ongoing education for both the member and provider.Assist members in accessing high-quality customer care and connect them to health plan and community resources to address needs (including Social Determinants of Health).
Serve as front-line support for member and/or provider inquiries, requests, or concerns, including explaining care plan procedures and protocols.Support member onboarding and day-to-day administrative duties, such as sending welcome letters, related correspondence, and program educational materials.Document and maintain non-clinical member records in compliance with state and regulatory requirements; provide records to providers as needed.Utilize knowledge of existing benefits and resources to make referrals and support member access to services.Perform other duties as assigned and comply with all policies and standards.QualificationsEducation: High School diploma or GED required.Experience: 1–2 years of related experience.
Member or patient-facing experience; experience with high call volume (50+ inbound/outbound calls daily) preferred.Knowledge: Familiarity with basic medical terminology; knowledge of benefits and resources locally; ability to make referrals for SDOH needs.Skills: Strong communication, organization, and computer literacy (MS Office).
Ability to enter assessments and notes into charting systems.Nice to have: Experience in a managed care setting, medical office, or related environment; ability to work with pediatric populations (0–20) and care coordination services.Must haves: 2–3 years in a managed care setting, medical office, or equivalent; member or patient-facing experience.OtherComments for Vendors: May be required to come on-site once a month for a meeting.EEO Statement: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of race, color, religion, sex, national origin, age, disability, or veteran status.Note: This description reflects the core responsibilities and qualifications and does not include unrelated internal notes, project details, or extraneous vendor information that does not pertain to the role.
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