City/State

Virginia Beach, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health Plans is currently hiring a Patient Services Coordinator!

This is a full-time remote position with day shift hours. This is a 100% telephonic position focused on outbound calls to Sentara Health Plans members.

Required Qualifications:

• High School Diploma or Equivalent

• Minimum 2 years of clinical experience

Primary responsibilities include:

• Working with members of the professional health care team and with community service agencies to coordinate care for members to improve health outcomes

• Assists with gathering information for the health care team regarding barriers or other health information

• Implements the interventions to promote improved health and compliance with recommended plan of care, as approved by the Health Care Team, including functions associated with the screening for changes in health status, coaching for improved self-management, reminders of necessary testing as determined by clinical guidelines, and support of the professional clinical staff in Health Care Services

• Serve as a key resource in supporting the clinical authorization processes, coordinating linkage between members, primary care providers, specialty providers and other insurance companies

• Supporting the referral process from providers, as well as pre-authorization approvals for medications and other services as ordered/requested by providers

• Provide other general administrative functions such as drafting correspondences, scheduling appointments, organizing and maintaining records and files, and providing assistance to members.

Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

With more than 30 years’ experience in the insurance business and 20 years’ experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services – all to help our members improve their health.

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B , 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks and more.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

Keywords: Health Plan, Case Management, Integrated Care, Care Coordination, MCO, Medical Care Management, Administrative Care, Doctor Office, Admin Associate

Job Summary

Patient Service Coordinator works in a collaborative role with all members of the professional health care team and with community service agencies to coordinate care for members to improve health outcomes. Assists with gathering information for the health care team regarding barriers or other health information. Implements the interventions to promote improved health and compliance with recommended plan of care, as approved by the Health Care Team. This includes functions associated with the screening for changes in health status, coaching for improved self-management, reminders of necessary testing as determined by clinical guidelines, and support of the professional clinical staff in Health Care Services.

May serve as a key resource in supporting the clinical authorization processes, coordinating linkage between members, primary care providers, specialty providers and other insurance companies. Includes supporting the referral process from providers, as well as pre-authorization approvals for medications and other services as ordered/requested by providers. May provide other general administrative functions such as drafting correspondences, scheduling appointments, organizing and maintaining records and files, and providing assistance to members.

Qualifications:

HS - High School Grad or Equivalent (Required)

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