Healthcare Case Coordinator

Therapy Management

• Accept ownership for managing new and existing therapy requests.
• Comprehensively assess member treatment needs and collaborate with providers and specialty pharmacies to prioritize member’s therapy needs.
• Maintain accurate and thorough documentation of all interactions and therapy updates.
• Continuously monitor and evaluate member's therapy plans and progress.
• Balance multiple responsibilities including case management, and inbound and outbound contact while demonstrating skill flexibility to ensure seamless service delivery.

Member Advocacy

• Take the time to understand each member's unique needs, preferences, and circumstances.
• Advocate for members' needs and preferences in therapy decision-making processes.
• Assist members in navigating barriers and explain their options for receiving their medications.
• Provide members with information and resources to help them make informed decisions about their therapy options. Empower members to participate in their treatment planning and decision-making process actively.
• Advocate for adjustments to therapy plans or additional support services if needed to optimize outcomes and ensure members receive the care they need.

Case Resolution and Problem-Solving

• Resolve member cases and inquiries in a timely and efficient manner, demonstrating strong critical thinking skills and attention to detail.
• Review and resolve next-level questions or concerns from members, providers, and pharmacies.
• Critically evaluate scenarios, anticipate potential challenges, and adapt your approach to meet member's evolving needs effectively.

Communication and Collaboration

• Communicate member progress by proactively informing members of their therapy status, and therapy options and intervening in crises for the member providing personalized communication.
• Manage communication with providers and consistently ensure professional and empathetic communication, fostering positive relationships and ensuring a high level of member satisfaction.
• Work closely with other departments to coordinate resources and address member inquiries or concerns effectively.

Requirements

• Have at least 3 years of experience in the healthcare industry, focusing on care coordination, member advocacy, or related roles.
• Demonstrate 3 or more years of customer service experience, case management preferably in healthcare. Call center experience is a plus.
• Proven experience working in a high-volume, fast-paced, evolving team environment.
• Ability to problem-solve, positively adapt to changing working conditions and multi-task.
• You are passionate about improving healthcare and helping people and have demonstrated success in a similar role.
• You are an exceptional communicator who can quickly get up to speed with the VIVIO Health program and effectively articulate its benefits.
• You are responsible and reliable and take ownership of your work while looking to constantly improve your performance.
• High attention to detail
• Experience with Amazon Connect is desirable
• High school diploma or GED.
• Available to work a full-time role between the hours of 6 am PT- 5 pm PT (9 am ET-8 pm ET)
• Bilingual is a plus.