The Care Management Support Assistant 2 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 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Effectively answer inbound calls on the TRICARE Autism Care Demonstration utilizing available resources. Address customer needs, which may include complex benefit questions, issue resolution, and beneficiary & provider education. Resolve customer service issues in a professional and courteous manner. Effectively communicate information with internal and external customers. Must also have exceptional verbal & written communication skills and the ability to discuss issues with customers (beneficiaries & providers). These types of communication may include telephony, secure email, web chat, co-browse, etc. Prioritize workload to continuously answer incoming calls and maintain established schedules and deadlines. Utilize information systems for maintenance and reporting issues. Ability to problem solve to address concerns and issues regarding services provided under the ACD. Support case management by coordinating services and researching necessary resources to support the beneficiary and increase access to services within required timeframes; receive and direct incoming phone calls to the appropriate CM to address beneficiary concerns and needs. Conduct outreach to ensure beneficiaries have appointments, document if they are choosing to see providers with wait lists, and look for trends in states where access issues need to be addressed.
- Identifies call and call inquiry. Documents calls through automated system in accordance with established guidelines. Self manages time to ensure sufficient time on task to achieve individual performance standards.
- Works collaboratively with ACD & Call Center Leaders, Supervisors and other department contracts regarding clarification or interpretation of established guidelines.
- Demonstrates problem solving ability utilizing analytical skills in order to process and interpret data from multiple sources.
- Directs applicable issues and questions to the appropriate level and area within the department.
- Consistently recognizes, promotes, and delivers quality customer service to ensure accomplishment of departmental and government goals.
- Educates beneficiaries and providers regarding the TRICARE ACD program, consistently providing complete and accurate information; demonstrates thorough knowledge of all TRICARE plans and eligibility for ACD benefits.
- Organizes, interprets, and formulates reference documents used within the department and throughout the company.
- Supports and participates in process and quality improvement initiatives.
- Other tasks as assigned.
- Our Department of Defense Contract requires U.S. citizenship for this position.
- Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing).
- High School Diploma or GED
- Two years prior healthcare/insurance experience.
- Above average written and verbal skills, including organizational abilities.
- Proficiency in Microsoft Office programs specifically; Word, Excel and Outlook.
- Computer experience including data entry.
- Ability to handle multiple projects simultaneously and to prioritize appropriately.
- Ability to handle high volume of calls and customer contacts in a polite and professional manner.
- Must have a separate room with a locked door that can be used as a home office, to ensure you and your patients have absolute and continuous privacy while you work.
- Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
- Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10-panel drug test.
Additional InformationThe following policy applies ONLY to associates working in the state of Arizona:
- Bachelors Degree.
- Knowledge of Autism Spectrum Disorder, specifically about Applied Behavior Analysis and other related therapies.
- Military health care service experience or working knowledge of TRICARE ACD program.
- Direct or Indirect Military experience a plus.
- Bilingual a plus.
Humana is committed to providing a safe and healthy work environment and to promoting the health and well-being of its associates.Effective July 1, 2011, Humanaadopted a tobacco-free hiring policy that will promote a healthier workplace and will not hire users of tobacco and nicotine products.If you have any questions, please consult with your recruiter.Work Days/Hours
: Monday - Friday; must be able to work an 8 hour shift between 8:00 am - 7pm EST.Training/Training Hours:
Mandatory for the first 4 - 6 weeks; 8:00am - 4:00pm ESTInterview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.Scheduled Weekly Hours
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