Integrated Care Program Specialist

Health Plan of San Mateo • Full-time • US • $28 - $35 / hour • 1m ago

Language Proficiency: English, Tagalog

General Description

This role is responsible for providing lead administrative support and assistance to the Integrated Care Management team. Primary focus is responding to integrated care management requests, data entry of medical records, data reporting, member screening and outreach, maintenance of tracking census and reports, and assistance in linking members to appropriate benefits and services.

Duties & Responsibilities

Essential Functions:

Process ICM Care Management team requests for member outreach, screening, education, referrals and follow ups.
Maintain and update the ICM Resource Guide, job aids, workflows, and other program materials to support ICM operations.
Maintain daily oversight of ICM SDP tickets via maintenance of ICM fax folders, emails and phone requests.
Assist members with appointments for specialists, educational classes, and transportation.
Work with healthcare providers to coordinate and share plans of treatment.
Perform data entry and data reporting and maintain updates for member information in ICM case management system.
Support with onboarding of all new hire ICM staff.
Assist ICM staff with meeting the care coordination needs of members.
Develop tracking reports related to census, program and service monitoring and utilization.
Participate in team meetings taking meeting minutes as needed.

Secondary Functions:

Perform other duties as assigned.

Qualifications

The following represents the typical way to achieve the necessary skills, knowledge and ability to qualify for this position:

Education and experience equivalent to:

High school diploma or GED required.

Integrated Care Program Specialist – Job Description

College level courses in health care, a plus.

One year of managed care experience, preferably in Care Coordination.
Experience working with the health needs of the population served.
Experience as a Medical assistant or Licensed Vocational Nurse is a plus.
At least one year of direct Care Coordination experience

Knowledge of:

Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.
Care management, Medi-Cal, and Medicare benefits as well as the complexities of working with the elderly and disabled population.
Community resources.

Abilities: