JOB DESCRIPTION:
- Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.
- Troubleshoots when an appropriate provider, type of service, or appropriate level of care cannot be readily found.
- Has current knowledge or research availability of community resources and services and links members to appropriate services.
- May assist in transitions in care for hospitalized patients and make appropriate placements, if needed.
- Assumes responsibility for self-development and career progression.
- Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role.
- Assists in the mentoring and training of new Care Workers.
- Remains responsible for updating self on ever-changing information to ensure accuracy when dealing with members and providers.
- Coordinates and manages the distribution of correspondence and materials to enrollees and providers. Participates in operational activities, including data collection, tracking, and analysis.
- Make outbound calls to various providers in California, coordinate with members, and provide scheduling assistance.
RESPONSIBILITIES:
- Experience in a managed care environment, integrated medical and behavioral health care, and/or training in chronic pain management.
- Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources.
- For roles supporting the Chronic Pain Management SBU, an understanding of Chronic Pain Management guidelines and workflows is also required.
Top 3 Must-Haves (Hard Skills):
- Proficient in Microsoft (Word, Excel, Outlook, Excel)
- Public Outreach experience
WORK EXPERIENCE:
- Managed Care
EDUCATION:
- Associates (Preferred)
- High school diploma or GED required
6-month contract position
100% remote but MUST reside in California
Monday – Friday 8:30 AM – 5 PM
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!