Care Management Support Assistant 3

The Care Management Support Assistant 3 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Management Support Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

Responsibilities

The Care Management Support Assistant 3 Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.

• Work with members thru telephone communication to review their health information for Medicare members
• Complete provider outreach within specified timeframes to obtain standard patient clinical information for all patients identified for review, per program workflow and protocols.
• Complete provider outreach on a daily basis to collect and update discharge information in the clinical system.
• Monitor receipt of requested patient Health Information into assigned inbox and prepare for Case Management nurse to use the information through timely identification and labeling
• Complete required documentation and perform other responsibilities as necessary
• Ability to multi task and document accurately
• Complete required documentation and perform other responsibilities as necessary
• Work with Medicare Members thru telephone (outbound) to complete the Health Risk Assessment in a period establish by CMS-Medicare.
• Receive mail, email or Fax the Health Risk Assessment and work in a time frame established to meet and exceed our goals
• Work on various letters, educational material and other documents for Medicare Members.
• Occasionally, you will visit some PR towns in Humana's network and complete Health Risk Assessment to the Medicare members invited.
• Documents sent by doctors by email or fax, should be worked on the patient's file.

Required Qualifications

• Associate degree or equivalent job experience (at least 2 years)
• Capacity to manage multiple tasks
• Excellent oral and written communications skills in Spanish
• Ability to work under tight schedule and under pressure
• Proficiency in Microsoft Office applications, including Word, Excel and Power Point

Preferred Qualifications

• Bilingual English/Spanish - desirable - Candidate selected will not be communicating in English with Members.
• Previous healthcare experience
• Previous outbound call center experience
• Knowledge in Medical Terminology (ICD-9, CPT, HCPC's)
• Computer system knowledge.

Additional Information

• Schedule: Monday to Friday from 8 am to 5 pm, Overtime, needed to work some weekends.
• Training: 2 weeks virtual and in person training at the San Juan Humana Building - 383 Ave F D Roosevelt. San Juan, PR 00918-2143

Humana Perks:

Full time associates enjoy:

• Base salary with a competitive commission structure and a monthly guarantee
• Medical, Dental, Vision and a variety of other supplemental insurances
• Paid time off (PTO) & Paid Holidays
• 401(k) retirement savings plan
• Tuition reimbursement and/or scholarships for qualifying dependent children
• And much more!

Social Security Task:
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

Virtual Pre-Screen:

As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a Modern Hire interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes.

Scheduled Weekly Hours

40