Evolent Health, Inc. Louisville , KY 40202
CARE CONNECTOR TECHNICIAN
It's Time For A ChangeYour Future Evolves Here
Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? Absolutely56.7% in year-over-year revenue growth in 2016. Are we recognized? Definitely. We have been named one of "Becker's 150 Great Places to Work in Healthcare" in 2016 and 2017, and one of the "50 Great Places to Work" in 2017 by Washingtonian, and our CEO was number one on Glassdoor's 2015 Highest-Rated CEOs for Small and Medium Companies. If you're looking for a place where your work can be personally and professionally rewarding, don't just join a company with a mission. Join a mission with a company behind it.
What You'll Be Doing:
Conducts outbound member calls following scripted protocols meeting both productivity and performance expectations as identified by the Manager and/or designee. Conducts all calls in a courteous and customer friendly manner.
Verifies member eligibility according to the appropriate eligibility system.
Documents agreement to participate in Care Coordination program according to prepared script and protocols.
Conducts outreach calls, collecting demographic and survey data according to script, tools, and protocols. Refers member to a case/care manager when indicated based on established guidelines.
Communicates directly with members to identify any care coordination needs and to provide information regarding health care access and preventive health interventions/screening.
Completes member specific interventions according to program guidelines and the member specific care plans developed by case/care managers.
Identifies members immediate and future CM, Special needs, Behavioral Health, and Disease Management needs according to program guidelines.
Improves and/or maintains the member's health status and quality of life.
Educates members regarding community resources and access to care.
Increases member's adherence to program guidelines by coordinating with primary care physicians.
Interacts with providers and other plan staff as needed to meet member objectives and improve health outcomes
Reports member status/progress to the designated case/care manager and Manager and/or designee.
Performs clerical responsibilities such as processing/scanning documents, mailing requests, faxing documents, and document retrieval.
Enters member data into various software platforms: Identifi, EPSDT application, Incentive application and Mommy Steps database.
Communicates case specific information as indicated to providers. Information includes, but is not limited to, member identification number, status of health screens and immunizations.
Assists members with: obtaining physician appointments, resolving transportation issues, obtaining appointments for preventive health screenings, and telephonic appointment reminders.
Assists with the generation and processing of member correspondence and educational material.
Documents information required for the purpose of outcome measurements.
Participates in program activities and project work.
Attends required training on an annual basis.
Complies with Passport and HIPAA confidentiality standards to protect the confidentiality of member information.
Completes reports as requested by Supervisor or Manager, such as incentive reports or individual production reports.
HRA entry via forms received in the mail or during inbound/outbound phone calls.
Perform other duties and projects as assigned.
Key Competencies/Success Factors:
Lives the values: Integrity, Community, Collaboration and Stewardship, as defined in the performance appraisal.
Strong project management, time management, and leadership skills.
Proficient experience using Outlook, Word, Excel and PowerPoint in a Windows operating system.
Solid problem-solving and business acumen skills.
Able to manage multitask work in a strong-paced environment.
Able to work alone on a broad variety of projects.
Able to establish and maintain healthy working relationships with people in course of work.
Education, Training and Experience
Bachelor's degree preferred.
Medical assistant, home health aide, nursing assistant, or other similar health care para-professional training preferred.
1-3 years of experience as a Case Management Technician or comparable experience preferred.
Licenses, Registrations or Certifications
Certification as a para-professional, medical assistant, home health aide, or nursing assistant preferred.
Valid driver's license with car insurance.
Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.