Care Coordinator, Care Management at WellSense Health Plan

Care Coordinator, Care Management

WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

The Care Management Coordinator provides administrative and clerical support for the Care Management Department. In this role, the individual must be able to plan, organize, and prioritize work to ensure accurate and timely completion. The Care Management Coordinator performs complex administrative functions to support a multidisciplinary team of clinicians, community-based agencies and staff, and members and caregivers. The Care Management Coordinator is a key contact and department representative and must have excellent written and verbal communication skills. This skill is critical in facilitating communication among team members as well as providers regarding referrals, authorizations, scheduling appointments, and obtaining and documenting information. Assessment scheduling, data entry and tracking are other key functions. Perform other duties as requested.

Our Investment in You:

• Full-time remote work
• Competitive salaries
• Excellent benefits

Key Functions/Responsibilities:

• Generates and/or distributes member documents and files
• Data entry of confidential member information into multiple databases
• Generates simple reports for care management team
• Initiates and follows up on requests for provider information
• Assists in scheduling Primary Care Team meetings and exchanging information, facilitating communication among team members as needed
• Assists in managing and tracking required assessments and informing appropriate care management staff
• Schedules assessments, home visits, and other appointments as requested by the care management staff
• Data entry of assessments into member records and into State system that is timely and accurate
• Prepares materials for mailing upon request
• Answers telephone calls for department staff and takes accurate messages
• Knows when to escalate issues with staff, supervisors, providers, contracted vendors, etc. for resolution
• Performs general office duties including sorting mail, faxing, filing, photocopying, researching addresses and contact information
• Prioritizes tasks and ensures deadlines are met
• Provides excellent customer service skills
• Participates in group meetings to ensure policies, procedures and workflows are up to date and makes recommendations for process improvement
• Maintains and assists with filing systems.
• Assists in special projects and prepares materials, binders, presentations as needed
• Attends scheduled meetings and required training
• Assists with new staff training
• Regular and reliable attendance is an essential function of this position
• Maintains HIPAA standards and confidentiality of protected health information
• Other tasks as requested

Qualifications:

Experience:

• 2 years office/administrative experience particularly in a high volume office with data entry and customer service call centers

Education:

• Associate’s degree in Healthcare or business administration, or a related area or equivalent relevant work experience

Preferred/Desirable:

• Knowledge of medical terminology a plus
• Knowledge of care management software systems, claims systems (preferably Facets) for recording and obtaining information a plus
• Experience with health care databases
• Health plan/health care experience
• Bilingual skills, fluency in Spanish

Competencies, Skills, and Attributes:

• Ability to work as part of a team
• Highly organized and able to prioritize tasks with ability to meet deadlines
• Has excellent data entry skills and knowledge of Microsoft Office, in particular Word and Excel
• Excellent communication skills both oral and written
• Strong interpersonal skills and ability to work with consumers as well as professionals
• Attention to detail
• Knowledge of administrative functions and scheduling experience
• Able to work in fast-paced environment and take independent initiative

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees