"Position Purpose:
Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.
"Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
May support performing service assessments/screenings for members and documenting the member’s care needs
Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager
Provide education on benefits and resources available
Performs other duties as assigned
Complies with all policies and standards"
Education/Experience:
Requires a High School diploma or GED
Requires 1 – 2 years of related experience"
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
============
Position Purpose:
Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically. Member facing.
Story Behind the Need – Business Group & Key Projects
- Health plan or business unit
- Team culture
- Surrounding team & key projects
- Purpose of this team
- Reason for the request
- Motivators for this need
- Any additional upcoming hiring needs?
MHS Wisconsin
Family Team environment – we make it fun – 2x a month team meetings – group chat for questions – close team
Making outbound calls to members to complete a Health Needs Assessment. You will also receive inbound calls from members to complete their Health Needs Assessment. Average 50-70 outbound calls per day.
State Contract – Metric is 35% Screening Rate
High energy, high volume Call Center Experience, Self-starter, able to multi task, reliable, communication skills, health care experience, multi tasking with dual monitors
Typical Day in the Role
- Daily schedule & OT expectations
- Typical task breakdown and rhythm
- Interaction level with team
- Work environment description
8-5pm CST with an hour lunch
Call Volume and Productivity
Call audit metrics monthly
Audits on HNAs monthly
Compelling Story & Candidate Value Proposition
- What makes this role interesting?
- Points about team culture
- Competitive market comparison
- Unique selling points
- Value added or experience gained
Focused on engagement of employees; Overall job satisfaction of our employees; Focused on development; (NOTE: ended up creating roles for those who have excelled in the role to be able to keep them on the team)
Candidate Requirements
Education/Certification
Required: High School Diploma or equivalent
Preferred: Bachelor’s preferred, not required
Licensure
Required: n/a
Preferred: n/a
- Years of experience required
- Disqualifiers
- Best vs. average
- Performance indicators
Must haves: high volume Phone Customer svc experience in health care, Computer knowledge including Excel, Word and Outlook, 2-3 years managed care, experience with Medicare/Medicaid (will be working with Medicaid) Exp. directly working HC providers/patients
Nice to haves:
Disqualifiers:
- Minimum call center experience
- Candidate who have only worked with Providers – front office setting (example: doctor office setting) NEEDS additional insurance experience
- Most previous job must reflect needs for this position
- Please state if position was contract (job hopping)
Performance indicators:
- Call Volume 50-70 outbound calls per day
- Audit (Call Audit) – 90% or higher
- HNA Audit score – 90% or higher
Best vs. average: see below top must-have skills
- Top 3 must-have hard skills
- Level of experience with each
- Stack-ranked by importance
- Candidate Review & Selection
1
Phone Customer svc experience HIGH VOLUME / /communication skills / documentation and compliance
2
Complete knowledge including MS Office Excel, Word and Outlook/ technical & remote proficiency
3
2-3 years managed care or physician’s office experience/organizational and time management skills/problem solving and adaptability
Candidate Review & Selection
- Shortlisting process
- Second touchpoint for feedback
- Interview Information
- Onboard Process and Expectations
Projected HM Candidate Review Date:
1-2 days post shortlisting
Number and Type of Interviews:
1
Extra Interview Prep for Candidate:
TEAMS/ZOOM Video/Camera On
Required Testing or Assessment (by Vendor):
n/a
Manager Communication Preferences & Next Steps
- Background Check Requirements (List DFPS or other specialty checks here)
Regular background checks
- Do you have any upcoming PTO?
8/29
- Colleagues to cc/delegate
Rachel Bennett (Hiring Manager) – Bonnie
