Care Coordinator, BH

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 Coordinator, BH is a member of the Behavioral Health Care Management (BH CM) team whose role is to perform telephonic outreach and screenings of identified members and to provide coordination of BH and community resources. The Care Coordinator, BH supports members and providers across service areas, identifies facilities and programs, and advocates and coordinates care for the members to ensure access to BH services and to community resources that address social determinants of health. The Care Coordinator, BH triages for and collaborates with clinical staff to ensure members receive appropriate care management.

The Care Coordinator, BH collaborates with their clinical team members, the Customer Care department and other internal departments to support member needs.

Our Investment In You

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

Key Functions/Responsibilities

• Uses motivational interviewing skills to engage members into care management via telephonic outreach
• Provides information to members with the goal of increasing member knowledge and participation in their own healthcare management including but not limited to information on how to obtain resources; basic health information; information packets containing health information relative to the Member’s identified condition
• Maintains current knowledge of community resources for referral and linkage to meet Members’ needs
• Advocates for the Member and coordinates BH/SUD and community resources
• Answers and triages calls from the department’s toll-free line
• Monitors the team’s mailbox and relays information received to Care Managers and triages referrals received via email
• Triages cases to clinical staff
• Facilitates referrals, performs telephonic screenings, arranges wellness visits and provides appointment and preventative care reminders, as needed
• Coordinates and facilitates access to BH/SUD services, resolves issues related to social determinants of health and collaborates with providers, facilities, state agencies, BH CM team, and other departments
• Maintains accurate and timely documentation in the medical management information system (Jiva) in keeping with contractual requirements, internal policy and accreditation standards
• Partners with department leadership and team members to organize staff assignments, prioritize and triage activities and calls
• Provide administrative support to the BH CM team
• Responsible for preparing department data/reports assigned by Management
• Identifies opportunities for improvement in administrative workflows and processes
• Performs other associated tasks as assigned by Manager/Supervisor
  
  

Qualifications

Education Required:

• Associate’s degree required in health care or a related area
• Bachelor’s degree in psychology, social work, or related area (preferred)
  
  

Experience Required

• Experience in either a high-volume customer service call center, data entry office, or health care office administration department
  
  

Preferred/Desirable

• Prior customer service/call center experience
• Prior work with Medicaid population preferred
• Bilingual
  
  

Competencies, Skills, And Attributes

• Strong motivational interviewing skills
• Ability to engage members
• Strong oral and written communication skills
• Detail oriented
• Ability to work independently but also in a team setting
• Demonstrated strong organizational and time management skills
• Demonstrated ability to successfully prioritize, plan, organize and manage multiple tasks in a face-paced environment
• Intermediate skill level with Microsoft Office products - Outlook, Word, Excel
• Ability to effectively collaborate with health care providers and all members of the interdisciplinary team
• Knowledge of medical terminology strongly preferred
  
  

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. 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

Required Skills

Required Experience