Member and Recipient Services Coordinator (Full-time Remote, North Carolina Based)

The Member and Recipient Services Coordinator provide a broad range of customer service functions to individuals that contact the Tailored Plan (TP) Member and Recipient Services Call Center. This position provides general information regarding accessing services in the TP provider network, and on the various functions and processes of TP departments. This position assures consumers/guardians seeking routine services are referred to services or are transferred to licensed clinicians for clinical screening and triage.This position is full-time remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.Responsibilities And DutiesCustomer Service & Support Receive calls from members, recipients, and community stakeholdersProvide education to callers regarding all areas of TP functionsAvailability and appropriateness of contracted providers;General information about managed care and NC Medicaid Tailored Plans;General information about state-funded services and NC Medicaid Direct;Benefit plans and member/recipient eligibility for services;Choosing and changing member PCPs;Choosing and changing AMH+ and care management entities;Role and expectation of care management entities;Grievance and complaint procedures;Navigating the Alliance Health website and member portal;Eligibility and scheduling transportation; Eligibility and referral for value added servicesMaintain calm, helpful, appropriate demeanor and decision-making for all callers, including angry, abusive, threatening, and harassing callersInitial Coordination & TriageEscalate urgent and emergent calls to a licensed clinicianComplete routine screening and referral a timely mannerConsumer SchedulingAssist callers with addressing obstacles to accessing care and identify available resourcesEngage in follow-up activities to ensure consumers were seen for scheduled assessments and schedule aftercare appointmentsReschedule consumer missed appointmentsDocumentation & ReportingRecord consumer demographics in electronic health record (EHR)Record grievances resolved and/or pending resolutionReceive, answer and record provider inquiries in EHRDocument all incoming call activity in EHRReport patterns of atypical call and service seeking patterns to supervisorAdhering to WorkflowContinue work efforts without interruption while managing technological disruptions and outagesOperate and navigate a multi-function phone system with multiple software programs while managing caller needsOperate and navigate multiple software programs in course of all dutiesRead, integrate, and adapt procedural tasks in a rapidly changing, paperless work environmentWork independently to prioritize tasks and maintain idle status in call queue during high call volume and/or low staffing periodsMonitor incoming fax system and overflow vendor reports to ensure written referrals receive appropriate attention within expected time framesTrain incoming staff to job duties and functions of the call centerInteract with community services orally while receiving information orally and in writing via IM, when called upon to do soEngage interpreter services when needed and adjust communication accordinglyTroubleshooting of hardware and multiple software programs, including security protocols, VPN, and software behind the firewallMinimum RequirementsBachelor’s degree from an accredited college or university in Human Services or related field and four (4) years’ experience in a community, business or governmental program that delivers mental health support services (e.g., adults with mental illness, children with severe emotional disturbance, persons with developmental disabilities, adults and children with substance abuse disorders)Preferred: Master’s degree and clinical experience preferred.Knowledge, Skills, And AbilitiesKnowledge of the six-county area and its human services agencies, community resources, churches, schools, and related organizations that provide services to clients and their familiesKnowledge of TP care management programsKnowledge of state and federal client rights protection statues, regulations, and applicable lawsEffective written and oral communication skill, interpersonal skills, excellent customer service skillsAbility to analyze oral and written information to identify rights protection complaint issuesAbility to multitask, manage time, prioritize work, and use problem-solving approachesAbility to coordinate effectively with staff from various agenciesAbility to read, analyze, and interpret regulations, policies, and procedures to service providersAbility to execute work plans and coordinate work effectivelyAbility to operate computer equipment and generate reports and recordsProficient in using basic computer programs, internetAbility to learn specific data programs used for call center trackingAbility to triage caller needs for urgency and resolve issues in a calm and supportive mannerAbility to perform in a fast paced, ever changing and often high stress environmentSalary Range$25.75 - $32.83/HourlyExact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equityAn excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term DisabilityGenerous retirement savings planFlexible work schedules including hybrid/remote optionsPaid time off including vacation, sick leave, holiday, management leaveDress flexibility