Job Description

Overview

This is a short-term assignment.

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the supervision of the Manager, Integrated Care Management, the Care Extender - ECM is responsible for working as the liaison for all incoming referrals for Enhanced Care Management (ECM) members. The Care Extender - ECM is responsible for skillfully engaging IEHP members who are transferred to the Care Extender queue, screening them for ECM eligibility, and referring over to the attributed Community Based Care Management Entity (CBCME). The Care Extender - ECM plays a critical role in determining appropriate routing of referrals within IEHP and the community to meet the members’ needs. The Care Extender - ECM will utilize multiple care management platforms to formally document the member’s disposition.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Key Responsibilities

Act as a subject matter expert resource for internal and external contacts supporting all Health Care Organizations. This includes:

• Assist Enhanced Care Management leadership with operational tasks, telephonic functions, projects, tracking, and trending.
• Facilitate communication between internal departments and external entities.
• Support Coordinators on Model 2 CBCME teams needing assistance.
• Provide training/precepting for new staff to IEHP and Enhanced Care Management processes and operations.

Assist leadership with data collection, including Team Member metrics and process improvement initiatives

Work as part of a multidisciplinary team to ensure coordinated and continuous care of members

Perform initial outreach and engagement to Enhanced Care Management eligible members who have not been attributed to an Enhanced Care Management team.

Identify the appropriate Community Based-Care Management Entities (CB-CME) for the member.

Model the highest ethical behavior in relationships with co-workers, supervisors, members, Providers, and colleagues in the community.

Promote a collaborative and effective working environment within the Enhanced Care Management team by engaging in evidence-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on member case discussions.

Build and maintain positive working relationships with Providers, including, but not limited to, communication via in-person, over the phone, and through digital means such as email and fax.

Engage with members by letter, email, texts, and telephone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the member and their medical/behavioral team, as well as to increase the member’s sense of control over their whole health.

Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team.

Assist with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services.

Ensure documentation is accurate and in compliance with regulatory requirements and accreditation standards.

Participate in Health Plan staff meetings or other activities as needed.

Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Qualifications

Education & Requirements

• Two (2) years of customer service experience in any setting required
• Experience of successfully working within a team
• Experience in data entry
• Internal Candidate qualifications are:
• Not on a Performance Improvement Plan (PIP)
• Promotes an objective and collaborative working environment within their team
• Supports management in reaching department and Health Plan goals
• High School diploma or GED required

Key Qualifications

• Valid California Driver’s License preferred
• Knowledgeable about evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies
• Understanding of and sensitivity to multi-cultural community
• Understanding of and sensitivity to mental health conditions and addictive disorders
• Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both
• Understanding of, and a commitment to, high preforming team practices
• Strong organizational skills, typing 45 words per minute, proficient in Windows applications
• Highly skilled interpersonally, with excellent teamwork and relationship skills
• Highly skilled in interpersonal communication, including resolving conflict
• Able to sufficiently engage members and providers both on the phone and in person
• Has ability to deescalate escalated calls
• Able to multi-task High degree of patience
• Exhibits good Team Culture
• Telephone courtesy
• Demonstrated respect of peers and supervisors
• Requires minimum supervision
• Ability to take initiative and be proactive in competing tasks

Start your journey towards a thriving future with IEHP and apply TODAY!

Work Model Location

Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)

Pay Range

USD $23.98 - USD $30.57 /Hr.