SCOPE OF ROLE  

The Special Needs Plan Intake Coordinator supports a team of clinicians and support staff in the delivery of care coordination and case management services to Medicare Advantage Special Needs Program members. This individual is accountable for the coordination of program services according to program specifications to improve care outcomes via interaction with Bright members, their providers and available member support services. This role embodies a philosophy that maintains focus on members’ health, leading by serving as an example to assure members and providers have a positive experience with the services they receive. The Special Needs Plan Intake Coordinator ensures required components of a special needs plan are accomplished in a timely and complete manner. 

ROLE RESPONSIBILITIES 

The Special Needs Plan Intake Coordinator job description is intended to point out major responsibilities within the role, but it is not limited to these items. 

• Intake coordination of health coach assignments/scheduling; collaborates with other departments for clinical assignments. ​ 
• Outreaches members to complete the Health Risk Assessment tool. 
• Conduction of chart audits, data collection, medical record requests/reviews for ICT meetings and/or HEDIS data collection. ​ 
• Maintains Transition of Care Log, and tracks completion of visits, and sends reminders to nurses as needed. ​ 
• Assist in the facilitation of short enrollment form requests and submission to enrollment on an as needed basis. ​ 
• Other administrative duties to include team meeting preparation and documenting minutes unless otherwise delegated. ​ 
• Can do basic member outreach to complete appointment scheduling, inquire about demographics, inquire about quantities of supplies needed, etc. ​ 
• Work with assigned Health Nurse to coordinate home visits as needed, and to coordinate calls to members.  
• Effectively communicates, problem-solves, and maintains productive and effective interpersonal relationships. ​ 
• Supports the administrative efforts of the Care Management Programs department. 
• Assist with training of new staff.  

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE 

• High School Diploma or GED required, Bachelor’s Degree in a related field preferred 
• Medical Assistant (MA) certification or related experience and/or training; or equivalent combination of education and experience. 
• Two (2) or more years of experience within a consumer support/customer service function 
• One (1) year of healthcare related experience required 
• Awareness and experience with HIPAA requirements for healthcare communications preferred 
• Prior experience with URAC/NCQA accreditation preferred 
• Bilingual in Spanish/English is a must

PROFESSIONAL COMPETENCIES 

• Prioritizes and plans work activities; uses time efficiently and has the ability to multi-task. 
• Excellent communication skills, both oral and written 
• Approaches challenges calmly and objectively to identify the best solution 
• Capable communicator that can interact with others at multiple levels within the organization, customers and providers 
• Leads through influence and example 
• Strong operational mindset and uses data to draw insights 
• Thrives on driving results in a collaborative environment 

LICENSURES AND CERTIFICATIONS 

• Medical Assistant (MA) certification or related experience and/or training; or equivalent combination of education and experience. 

WORK ENVIRONMENT 

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel, up to 10% of the time may be required.