Case Management Coordinator - TRICARE

Job Summary:

This position supports TRICARE Prime® Demo by CareSource Military & Veterans, which aims to enhance healthcare access and prioritize the unique needs of the military community. We encourage military affiliated individuals, veterans, military spouses, and those with prior TRICARE experience to apply.

The Case Management Coordinator - TRICARE outreaches to engage beneficiaries in Care Management and provides linkage to resources to coordinate effective management of health conditions and biopsychosocial needs.

Essential Functions:

• Conduct outreach to beneficiaries to engage in the Care Management process
• Verify beneficiary eligibility, enrollment status, demographic data and current health / psycho-social needs status
• Assist beneficiary with questions relating to completion of HNA questionnaire
• Provide program or campaign support and assistance through engagement of special population beneficiaries (i.e. high ED utilizer, tobacco and vaping cessation, continuity of care)
• Provide educational material and resources to beneficiaries utilizing multiple delivery methods which could include telephone, email, beneficiary app, and mail services.
• Educate beneficiary on wellness programs and appropriately refer to case manager for additional assistance when needed
• Accurately document information and maintain manual data reports as requested by campaign
• Refer and assist beneficiaries to access community services and collaborate continuously with leadership on identification and documentation of updated resources
•  Assist beneficiaries to close gaps in care by removing barriers and access to care concerns
• Maintain appropriate and accurate documentation of all beneficiary interactions to ensure compliance with all regulatory reporting requirements and quality assurance standards
• Routinely use multiple internal computer applications and telephonic systems to provide assistance to beneficiaries
• Support assessment team with entering completed assessments into the clinical management system, as needed
• Perform any other job duties as requested

Education and Experience:

• High School Diploma or equivalent is required
• Associate’s Degree or other formal health education / certification is preferred
• Minimum of three (3) years of experience in healthcare, customer service or a related industry is required
• Previous experience in a clinical environment, medical terminology or health related classes is preferred
• Experience with military culture is preferred
• Military affiliation or TRICARE experience is preferred.

Competencies, Knowledge and Skills:

• Engage with beneficiaries using professional and effective communication skills via telephonic, electronic, or in-person contact
• Basic proficiency with Microsoft Office Suite to include Outlook, Word and Excel
• Knowledge of TRICARE and Managed Care is preferred
• Customer service focus with exceptional listening, written and verbal communication skills
• Displays professional etiquette
• Ability to multitask using a variety of computer applications
• Strong organizational skills
• Effective problem-solving skills with attention to detail
• Ability to work independently and within a team environment
• Adaptable to a constantly changing environment
• Able to type (document) and talk (telephonically) simultaneously

Licensure and Certification:

• Employment in this position is conditional pending successful clearance of a driver’s license record check.  If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource Military and Veterans requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource Military and Veterans adheres to all federal regulations. CareSource Military and Veterans provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need
• May be required to regularly travel to perform work duties.  A valid driver’s license, car, and insurance are necessary for work related travel
• Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our beneficiaries and may refer beneficiaries to other CareSource Military and Veterans resources

Compensation Range:
$35,200.00 - $56,200.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Hourly

Competencies:
- Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

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