Care Management Support Specialist
Humana

Description

Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state. CMSS do this by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Support Specialist performs varied activities and moderately complex administrative/operational/customer support assignments and typically works on semi-routine assignments. CMSS's work collaboratively with clinical support associates, (including nurses and social workers,) as well as with each other - as part of an interdisciplinary team.

Responsibilities

The Support Specialist daily assignments are focused on adherence to area/department policies and methods. The CMSS works within defined parameters to identify work expectations and quality standards in an area with frequently changing prioritization and timing. This role requires the ability to successfully work within outlined expectations, and within specific standards. Working hours for this position is an 8-hour shift, bases on business needs, between 9:30AM and 8PM Eastern Standard Time Mon-Fri. This role requires occasional mandatory overtime, which may include weekend hours.

In this production-based role, you will:

• Have a production-based quota
  
• Work with customers (members), business partners, and clinical partners
  
• Provide support for various lines of business
  
• Handle a combination of inbound and outbound calls
  
• Help route calls between departments, and teams
  
• Help provide members with educational resources
  
• Act as a point person on non-clinical issues
  
• Research and verify resources and/or referrals
  
• Assist with message/email routing to appropriate area, including shared e-mail boxes
  
• Schedule and support care conferences
  
• Utilize multiple applications/software throughout your day
  
• Assist with member assignment/routing
  
• Assist with other tasks as needed
  
• Successful candidates thrive in a collaborative team-based environment and values the unique perspectives of others
  
• Leverage clinical experience and expertise, as well as flexibility and openness, in new ways of working
  
• Be a part of an exciting and frequently changing environment
  

• 1- 3 years ofhealthcare administration or call centerexperience
  
• Able to work in a fast paced, multitask work environment
  
• Knowledge of Microsoft Word,Excel, and Outlook
  
• Experience meeting productivity metrics in a high-volume production-based work environment
  
• Excellent communication and interpersonal skills
  
• Access to a private/undisrupted work at home office space
  
• Access to high-speed internet
  
• Ability to work independently in a home office setting
  

• Associate degree
  
• 3+ years technical experience
  
• sales and/or customer service experience
  
• Administration support experience in the healthcare industry
  
• Bilingual in English and Spanish
  
• Office 365 and Cloud based services