Care Specialist (NYCE) - Remote

Summary of Position Responsible for the execution of the non\-clinical aspects of the Care Management process. Ensure information is appropriately entered in the system to effectively execute member care plans, originate authorizations, request clinical information, perform case research, and essentially execute all behind the scenes desk\-level procedures of a case. Work seamlessly with the Care Specialists, Care Managers and Social Workers (and other clinical staff) to ensure everything that a participant needs to tend to their health is addressed.Provide confidential administrative support and assistance to the department and support the department in all aspects of daily project operations.Assist the entire Care Management interdisciplinary team in managing members with Care Management needs.Provide telephonic outreach to members that have been identified for care management and ensure members’ needs are supported throughout the duration of member enrollment to the program, by completing screenings with members, coordinating with Care Manager on members’ care plan, making appropriate referrals to the interdisciplinary care team, coordinating post\-acute services on behalf of members, assisting with community resource needs and more. Provide services per the NYCE contract. Principal Accountabilities* Work collaboratively, as a critical component of the Medical Management team, to facilitate all clerical and administrative processes and activities. * Perform accurate and timely intake and data entry for all Care Management requests and referrals for all lines of business, upon receipt of inbound requests, via call, fax and web portal, in accordance with departmental policy and regulatory requirements. * Perform member telephonic outreach for program enrollment with the goal of retaining members in the Care Management Program. * Triage cases and assign receipts to appropriate teams. * Communicate and/or respond to inquiries from providers, facilities and members