Experienced Remote Customer Service Representative – Entry Level Position for Dynamic Healthcare Industry Leader at blithequark

Introduction to blithequark and the Industry blithequark is a pioneering force in the healthcare industry, dedicated to delivering exceptional patient care and innovative solutions. As a leader in serving dual-eligible populations, we are committed to using top-tier operational and clinical models to make a meaningful impact on the lives of our members. Our Double Special Needs Plan (DSNP) is designed to address the complex health and social challenges faced by individuals enrolled in both Federal Medicare and Medicaid.By joining our team, you will have the opportunity to collaborate with like-minded professionals, healthcare providers, and community organizations to drive positive change and improve health outcomes. Job Overview and MissionThe Case Management Specialist role at blithequark is a critical component of our care management team. As a Case Management Specialist, you will utilize your analytical skills and judgment to facilitate the case management process, ensuring that our members receive comprehensive and coordinated care.Your primary objective will be to collaborate with healthcare providers, community organizations, and internal stakeholders to address the full continuum of our members' healthcare and social determinant needs. Key Responsibilities Conduct comprehensive assessments of members' needs and eligibility using care management tools and data analytics, and recommend approaches to achieve case resolution or address needs. Identify high-risk factors and service needs that may impact member outcomes and care planning, and refer cases to clinical case management or crisis intervention as necessary.Develop, implement, and monitor care plan activities, and evaluate progress towards achieving desired outcomes. Enhance clinical appropriateness and quality of care by collaborating with case managers, supervisors, Clinical Directors, or other healthcare programs to overcome barriers to meeting objectives. Identify and escalate quality of care issues through established channels, and utilize discussion skills to secure appropriate decisions and services that meet members' benefits and healthcare needs.Provide coaching, information, and support to empower members to make informed decisions about their healthcare and lifestyle choices. Facilitate member engagement and participation in healthcare navigation, and ensure that members are actively involved in their care planning and decision-making processes. Monitor, assess, and document care management activities in compliance with regulatory and licensure requirements, company policies, and procedures. Essential Qualifications To be successful in this role, you will need to possess a strong foundation in healthcare, with a minimum of 3+ years of experience in a health-related field.A Bachelor's Degree or equivalent experience is required. You should be a team player with excellent communication and interpersonal skills, able to work effectively with diverse stakeholders, including members, healthcare providers, and community organizations. Preferred Qualifications Certifications such as CRC, CDMS, CRRN, COHN, or CCM are highly desirable. Experience working with Medicare and Medicaid, managed care, and geriatric special needs populations is preferred. Knowledge of assessment, screenings, and care planning is essential.Bilingual skills (English/Spanish; English/Creole) are a plus. Skills and Competencies To excel in this role, you will need to possess a unique blend of skills and competencies, including: Strong analytical and problem-solving skills, with the ability to think critically and creatively. Excellent communication and interpersonal skills, with the ability to build strong relationships with diverse stakeholders. Ability to work effectively in a fast-paced environment, with multiple priorities and deadlines.Strong organizational and time management skills, with the ability to prioritize tasks and manage multiple projects simultaneously. Ability to work independently and as part of a team, with a strong commitment to collaboration and teamwork. Career Growth Opportunities and Learning Benefits At blithequark, we are committed to the growth and development of our employees. As a Case Management Specialist, you will have access to a range of training and development opportunities, including:Comprehensive onboarding and training programs to ensure your success in the role.Ongoing professional development and education opportunities to enhance your skills and knowledge. Opportunities for career advancement and growth within the organization. A supportive and collaborative work environment that encourages innovation and creativity. Work Environment and Company Culture At blithequark, we pride ourselves on our dynamic and inclusive work environment. Our company culture is built on a foundation of respect, empathy, and compassion, with a strong commitment to diversity, equity, and inclusion.As a member of our team, you can expect: A supportive and collaborative work environment that encourages open communication and feedback. A range of employee recognition and reward programs to recognize your contributions and achievements. A comprehensive benefits package, including medical, dental, and vision coverage, as well as a 401(k) retirement savings plan and employee stock purchase plan. A range of wellness programs and employee assistance initiatives to support your physical and mental health.Compensation, Perks, and BenefitsThe salary range for this role is $19.52 - $40.90 per hour, depending on experience and qualifications. In addition to your base salary, you will be eligible for a range of benefits, including: A comprehensive benefits package, including medical, dental, and vision coverage. A 401(k) retirement savings plan and employee stock purchase plan. A range of wellness programs and employee assistance initiatives. Paid time off (PTO) and holiday pay, as well as a range of other time-off benefits.Conclusion If you are a motivated and compassionate individual with a passion for healthcare and customer service, we encourage you to apply for this exciting opportunity to join the blithequark team. As a Case Management Specialist, you will play a critical role in delivering exceptional patient care and driving positive change in the lives of our members. Don't miss this chance to make a meaningful difference and advance your career in a dynamic and supportive environment. to become a part of the blithequark team and start your journey towards a rewarding and challenging career in healthcare.