Care Coordinator / PAL Specialist Start Date: November 11 th 2024 Pay Rate: $20/hr Duration: 3 month contract Worksite Location: 100% Remote (Equipment Provided)Hours: Mon-Fri 8am-5pm PSTJob Description: The Personal Assistance Line (PAL) Specialist is the single-point of contact for all assigned dual members (Medi-Cal/Medicare). The PAL Specialist manages all initial & annual outreach to each assigned member, supports member understanding, access to integrated benefits & community services/programs, conducts Health Risk Assessments (HRAs), completes member Care Plans, resolves member service issues, & proactively assists members in navigating through healthcare & state eligibility systems. The PAL Specialist facilitates access to care with/on behalf of the member & engages clinical support (internal & external) for escalated member issues/care needs, & functions as a liaison between members, Health Plan, Medical Groups, Medi-Cal, providers & community based organizations. · Responsible for managing caseload of assigned Connections and Connections at Home members, including outbound call activity, as assigned, and prompt response to all inbound member calls. · Conducts assigned member welcome and follow-up calls designed to assist members with access to appropriate benefits, educate members, family and caregivers regarding benefit provisions, facilitate referrals, and resolve member issues with health care providers (medical, dental, vision and other supplemental benefits). · Conducts Continuity of Care assessments and facilitates member access to care. · Actively engages and collaborates with member to complete Health Risk Assessments, assisting member to identify health needs, and collaborating with member to develop health goals and create member plan of care. · Contributes to member satisfaction and retention by developing rapport, identifying member needs, making appropriate referrals, providing assistance and resolving escalated member issues. · Identifies quality concerns and works with Health Care Services, Quality Management staff and Provider Group Care Management to expedite the resolution. · Documents transactions by completing assessments, applicable forms and summarizing actions in computer system. · Understands the health plan’s benefit structure, medical group resources, community programs and resources and member-specific needs to proactively problem-solve and identify member-centered solutions · Adheres to all quality, compliance and regulatory standards to achieve Health Care Services and SCAN outcomes. · Actively support the achievement of SCAN’s Vision and Goals. Qualifications:2 years of healthcare call center experience Bilingual – English & Spanish High School Diploma Benefits Information: Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
