Description and Requirements
The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) and may have additional departmental responsibilities.
Duties and Responsibilities:
Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests
Review intake documents for pre-approved services and escalate discrepancies as needed
Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM.
Initiate and finalize authorization in Trucare for preapproved services and DMEs and update and discontinue authorizations when applicable
Handle and accurately document calls to and from members to assist with benefit questions/issues, schedule appointments, assessment inquiries, service issues and grievances
Handle and accurately document calls to and from providers regarding authorizations initiation/updates, referrals, visits, tests, and faxed care plans
Provide education to members and providers regarding requirements for approval of service requests
Manage a large caseload while communicating member issues or needs and monitoring screening of members effectively to improve quality and cost outcomes
Communicate with Inter/Intra-departments regarding reconciling onboarding issues
Additional duties as assigned
Minimum Qualifications:
High School diploma or GED equivalent
Experience in a customer service environment
Experience working in a fast-paced environment that requires handling multiple priorities simultaneously
Work experience requiring effective communication verbally and in writing while demonstrating good grammar, spelling, and punctuation skills
Preferred Qualifications:
Associate Degree/Certification in a related field
Knowledge of medical terminology
Can manage a caseload of 200+ cases
Knowledge of Trucare, Salesforce, HHAXchange, DocuSign Epaces, Sharepoint and Monday.com
Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department
Experience with Microsoft Office Suite applications including Excel, Word, Outlook, and MS Teams
Demonstrated ability to document calls into a computer system
Hiring Range:
Greater New York City Area (NY, NJ, CT residents): $40,200 - $54,570
All Other Locations (within approved locations): $34,900 - $52,000
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.
Know Your Rights
Healthfirst is a managed care organization that provides health insurance and healthcare management services across multiple product lines including Medicare Advantage, Medicaid Managed Care, Child Health Plus, Commercial Qualified Health Plans, Essential Plans, and Senior Health Partners. The organization focuses on member-centered care delivery, medication therapy management, utilization management, and grievance resolution across diverse populations. Healthfirst operates through various clinical and administrative teams to ensure appropriate, evidence-based care and regulatory compliance while supporting optimal health outcomes for its members.
