Company Description
Clearlink Partners is an industry-leading managed care consultancy specializing in end-to-end clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special Needs Plans, complex care populations, and risk-adjusted entities.
We support organizations as they navigate a dynamic healthcare ecosystem by helping them manage risk, optimize healthcare spend, improve member experience, accelerate quality outcomes, and promote health equity.
Position Responsibilities
Specific
- Gather and organize documentation to support care management process
- Review available information and interview patients to document needs and potential interventions
- Educate patients about their condition, medication, and available resources
- Provide input into the care planning process to address their personal health care needs
- Provide referrals and coordination to access available community resource programs and supports
- Consult and collaborate with other health care team members and specialists to set up patient appointments and treatment plans
- Check-in on the patient as designed, evaluate and document progress and coordinate progress with RN CM
- Assist the care team with developing and assessing effectiveness of healthcare interventions
General
- Maintaining timely and effective internal and external communication regarding assigned work/ tasks
- Logging, tracking, and ensuring completion of all work in compliance with contract service standards
- Tracking review completion of assigned work to ensure final closure/ resolution
- Managing high workload volumes, ensuring accuracy and compliance with contractual deadlines
- Ensuring all necessary information is available and organized for professional staff review/resolution
- Outreach as necessary for clarification or collection of additional information needed
- Perform all job functions with a high degree of discretion and confidentiality in compliance with federal, company & departmental confidentiality guidelines
Position Qualifications:
Competencies
- Excellent oral and written interpersonal/communication
- Strong internal/external customer-service, organizational, multitasking, and teamwork skills
- Excellent analytical thinking/problem-solving skills
- Proficiency in Microsoft Office
- Ability to perform critical analysis and facilitate/ promote positive outcomes
- Ability to work effectively in a fast-paced environment with multiple priorities, deadlines, and workloads
- Ability to offer positive customer service to every internal and external customer
Experience - Experience with population health management, including care coordination practice in multiple lines of business (LOBs) including Medicare Advantage, Managed Medicaid, Dual SNP, & Commercial Lines of Business
- 2+ years of experience work for a Managed Care (Payer)
- Bachelor’s Degree Required, LPN Preferred
- Knowledge of current access and care standards
- Knowledge of referral process for community resources and care coordination services
- Knowledge and competency with a variety of potential member needs, community resource availability and available support programs
Physical Requirements
- Must be able to sit in a chair for extended periods of time
- Must be able to speak so that you are able to accurately express ideas by means of the spoken word
- Must be able to hear, understand, and/or distinguish speech and/or other sounds in person, via telephone/cellular phone, and/or electronic devices
- Must have ample dexterity which allows entering of text and/or data into a computer or other electronic device by means of a keyboard and/or mouse
- Must be able to clearly use sight so that you are able to detect, determine, perceive, identify, recognize, judge, observe, inspect, estimate, and/or assess data or other information types
- Must be able to fluently communicate both verbally and in writing using the English language
- Must be able to engage in continuous social interaction, successfully manage stressful high conflict situations, and balance multiple duties, expectations and responsibilities simultaneously
Time Zone: Eastern or Central
Other Information
- Expected Hours of Work: Friday 8am – 5 pm; with ability to adjust to Client schedules as needed
- Travel: May be required, as needed by Client
- Direct Reports: None
- Salary Range: $48,000 - $75,000
EEO Statement
It is Clearlink Partners’ policy to provide equal employment opportunity to all employees and applicants without regard to race, sex, sexual orientation, color, creed, religion, national origin, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit-based factor in accordance with all applicable laws, directives and regulations of Federal, state and city entities. This salary range reflects the minimum and maximum target wage for new hires of this position across all US locations. Individual pay will be influenced by Experience, Education, Specialized Soft Skills, and/or Geographic location.