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Care Worker
Ref No.: 18-12867
Location: Miami, Florida
Job Title: Care Worker
Job Location: Miami, FL
Job Duration: 3 Months Contract 

Job Description:

Facilitates department workflow by supporting clinical team with various care coordination workflows. Locates community services and other referral locations for enrollees, arranges access to care, supports communication with hospitals, and providers.

ESSENTIAL FUNCTIONS:
  • Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.
  • Trouble shoots when an appropriate provider, type of service, or appropriate level of care cannot be readily found.
  • Has current knowledge or researches availability of community resources and services and link members to appropriate services. May assist in transitions in care for hospitalized patients and makes appropriate placements, if needed.
  • Assumes responsibility for self-development and career progression. Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role. Assists in the mentoring and training of new Care Workers.
  • Remains responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
  • Coordinates and manages distribution of correspondence and materials to enrollees and providers.
  • Participates in operational activities, including data collection, tracking, and analysis.

Requirements/Certifications:
  • Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources.
  • This is a mostly clerical/admin position doing inpatient and outpatient authorizations.
  • Will have to make some outbound calls to collect information or get corrected info. (NOT CALL CENTER)
  • Prior Authorization experience not required and can be trained, but is a plus.
  • Education or experience in Healthcare a plus.
  • Candidates that have worked in a medical office of some sort are a good fit as well.
Education:
High School or GED
Hours: Sunday 8:30-4 pm Monday-Thurs 10:30-7pm