Care Management Support Assistant

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The Care Management Support Assistant 2 - Autism Care Demonstration (ACD) Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program.
Care Management Support Assistant 2 Key Accountabilities

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You will recognize ACD specific assessments/treatment plans and pend referrals and authorizations for review.

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You will coordinate authorizations with Autism Services Navigators and Utilization Management. You will answer questions from associates and MTF/ civilian providers to obtain additional information that may complete referrals.

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Data entry into medical management system, eligibility reviews, reviewing for ECHO benefits, non-clinical overview of assessments

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Complete documentation to pend tasks to appropriate queues who can complete or request additional information.

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You will answer inbound calls on the TRICARE Autism Care Demonstration using available resources. Educate beneficiaries and providers regarding the TRICARE ACD program.

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You will monitor the phone queues and web chats to answer provider/beneficiary inquiries.

You will report to a Supervisor of Care Management Support.

Use your skills to make an impact

Required Qualifications

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Work a shift of 10:30 a.m. - 7 p.m. E.T. to help handle internal phone queue

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2 or more years of medical coding and/or behavioral health experience

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3 or more years of experience in customer service or referral management position (handling high volume of work with a deadline)

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3 years of experience in healthcare/medical or health insurance field

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Our Department of Defense Contract requires U.S. citizenship for this position

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Successfully receive approval for government security clearance (Via National Background Investigation Services NBIS)

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HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico

Preferred Qualifications

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Military health care service experience or working knowledge of TRICARE entitlement program

- Bachelor's degree

Additional Information

Work Days/Hours : Will work an 8-hour shift of 10:30 a.m.-7 p.m. EST, Monday through Friday

- Overtime per business need

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Training hours: Mandatory for the first 4-6 weeks: 8 a.m.-4:30 p.m. EST

Work Style : Remote
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana 's offices for training or meetings may be required.Florida Background Screening Requirements: Notice for candidates applying to this position from a Florida work location, including Florida home-based work location. This position is subject to Florida Level 2 background screening through the Care Provider Background Screening Clearinghouse. For information about the screening process and requirements, visit: Scheduled Weekly Hours
Pay Range
compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$39,000 - $49,400 per year Description of Benefits
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