Care Management Support Assistant 2 - Behavioral Health

The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Management Support Assistant 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
The Care Management Support Assistant 2 Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Assist Care Managers (CM) in ensuring TRICARE beneficiaries receive the highest quality health care by assisting in the management of calls and tasks of Care Managers. Support case management by coordinating services and researching necessary resources to support the beneficiary and increase access to services within required timeframes; receive and direct incoming phone calls to the appropriate CM to address beneficiary concerns and needs. Support the CM in meeting the policies and procedures for the Case Management programs. Conduct outreach to ensure beneficiaries have appointments, document if they are choosing to see providers with wait lists, and look for trends in states where access issues need to be addressed.
Our Department of Defense Contract requires U.S. citizenship for this position
1. Assists with incoming communications to the CMs by directing the calls to the appropriate personnel and assisting in answering questions and needs for enrollment. Assists with beneficiary related concerns to include claims inquiries, enrollment issues, travel attestations, access to care, wait lists and other non-clinical beneficiary concerns. Interface with providers on claims / billing concerns and follow issues through to resolution. Discuss details of problems with as needed.
2. Monitors reports to ensure appointments are completed within specified timeframes, assists in verifying ECHO eligibility and other duties as assigned.
3. Perform telephonic customer service functions with beneficiaries throughout the United States with a focus on services provided under the ACD and ECHO as outlined in the TRICARE Operations Manual (TOM), the TRICARE Reimbursement Manual (TRM), and the TRICARE Policy Manual (TPM).
Assist with questions regarding the status of referrals/authorizations for beneficiaries with qualifying ASD diagnoses for retirees and active duty beneficiaries.
Provide professional and courteous service to all callers and work to resolve any complaint or issue to their satisfaction when possible.
Follow the promise of excellence by adhering to "It is not my fault, but it is my problem" to limit any call transfers to other areas and provide resolution to caller's needs.
4. Communicates effectively with all disciplines of the medical and beneficiary community.
Required Qualifications
Healthcare professional with a minimum of a Bachelor's degree in social work, psychology, or related health discipline from an accredited university. (5 years of related experience may be substituted for degree)
Minimum 3 years' experience working in a clinic, hospital case management or other health care setting
Ability to handle high volume calls and customer contacts in a polite and professional manner
Two years of health care/managed care experience
Good organizational and mulit-tasking skills
Above average written and verbal skills including organizational abilities
Computer experience including data entry
Must be available to work 9:30 AM ? 6:00 PM CST
Preferred Qualifications
Direct or Indirect Military experience a plus
Previous experience Behavioral Health or Social Services field
Additional Information
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly
connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive a correspondence inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone
and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 20 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you
will be moving forward to next round of interviews.
Scheduled Weekly Hours

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