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Are you looking to use your skills in a Program Coordinator position? This client is Hiring Now!  The client is looking for a candidate that is able to assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. The ideal candidate for this position will possess a High school diploma or equivalent, 2-3 years managed care or physician’s office experience,  Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer and Knowledge of medical terminology. If this position interests you, apply today! Candidate must speak Spanish and English! salary: $18 - $18 per hourshift: Firstwork hours: 10:30 AM - 7 PMeducation: High` SchoolResponsibilities Program Coordinators works in our Inbound Call Center which follows established metrics: Talk time, Hold Time, After Call Work. Liaison between Members/Provider and the Case Coordinator. Assist with Long Term Care (Member/Provider) calls for Sunshine Health. Triage/Route calls correctly. Unless member/provider insists that they only want to speak to Care Coordinator, the team will try to resolve issues brought up by the caller before the call is routed to CC or Sup. Assist with providing status of services and supplies. Assist to resolve missed visits, missed transportation or missed supplies - reaching out to Provider for status and update authorizations as needed. Review authorizations and assist with correcting authorizations, as allowed and as needed, to match the Member’s Person Center Care Plan. Helping member/authorized representative with filling out forms that the health plan mails out.  SkillsClaims ProcessingSchedulingBenefits AdministrationCustomer ServiceQualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. For certain assignments, Covid-19 vaccination and/or testing may be required by Randstad's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Randstad representative for more information.

Are you looking to use your skills in a new Program Coordinator position? This client is Hiring Now!  The client is looking for a candidate that is able to assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. The ideal candidate for this position will have a high school diploma or equivalent,  thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer, knowledge of medical terminolog and 0-2 years of experience in a related industry.  If this position interests you, apply today!   salary: $24.75 - $24.75 per hourshift: Firstwork hours: 8 AM - 5 PMeducation: High` SchoolResponsibilities Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs. Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan. Skills Program Coordinator Medical ManagementQualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. For certain assignments, Covid-19 vaccination and/or testing may be required by Randstad's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Randstad representative for more information.

Are you looking to use your skills in a new Program Coordinator position? This client is Hiring Now!  The client is looking for a candidate that is able assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Candidate will place outbound calls to members to engage in care management. Candidate will attempt outreach calls to member and providers, present/introduce care management program to members and complete appropriate documentation. If this position interests you, apply today! salary: $24.75 - $24.75 per hourshift: Firstwork hours: 9 AM - 6 PMeducation: High` SchoolResponsibilities Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.  Skills Program Coordinator Medical ManagementQualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. For certain assignments, Covid-19 vaccination and/or testing may be required by Randstad's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Randstad representative for more information.