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CareSource

Member-first health plan: Marketplace, Medicare, Medicaid

Clinical Support Specialist

Clinical Support & Patient AdministrationPosted on Nov 10
Full-timeRemote

About the Job

Requirements

  • A high school diploma or GED is required.
  • Completion of a Medical Assistant, Community Health Worker, or similar training program is required.
  • Two years of experience working in a health care setting as a Medical Assistant, Community Health Worker, or similar position is required.
  • Ability to work effectively with patients, colleagues, and vendors from diverse backgrounds.
  • Proficient knowledge of medical terminology, including health insurance terms and concepts.
  • Proficiency in Microsoft Office Suite, including Outlook, Word, Excel, and Teams.
  • Competence working within an electronic medical record.
  • Ability to maintain strict confidentiality when handling sensitive medical information.
  • Ability to provide compassionate customer service.
  • Ability to recognize and escalate urgent or emergent issues in a timely manner.
  • Familiarity with preferred methods of communication and telecommunications guidelines.
  • Bilingual/bicultural Spanish ability.
  • Knowledge of motivational interviewing.
  • Ability to navigate social and community services.
  • Data analysis and reporting skills.

Responsibilities

  • Field lab-related questions from lab vendors, patients, and providers.
  • Respond to patient calls regarding test results, prescriptions, and other non-urgent clinical matters.
  • Monitor and respond to the Clinical Support email inbox, escalating matters to the nursing team as indicated.
  • Cross-train as a Mobile Health Coordinator to conduct intakes and process requests for referrals.
  • Review, validate, and process medical records requests from patients in a timely manner.
  • Ensure instED visit notes are consistently sent to patients’ primary care providers and other pertinent care providers, and connect primary care providers to clinicians when necessary.
  • Conduct follow-up phone calls to patients after an instED visit, as directed by nurses and providers.
  • Manage the administrative aspects of the Athena clinical inbox.
  • Follow up on safety concerns reported by the mobile health provider workforce.
  • Maintain knowledge of community resources in Massachusetts.
  • Initiate and facilitate patient referrals to community organizations and primary care providers in their health plans’ networks.
  • Provide ongoing daily administrative support to Clinical Resource Center nurses as directed.
  • Coordinate follow-up care with external care teams, as directed by Virtual Medical Control providers.
  • Transfer or escalate issues to licensed independent practitioners as appropriate.
  • Document and report successful and unsuccessful patient outreach.
  • Participate in quality and process improvement initiatives.

Desired Qualifications

  • A Bachelor's degree is preferred.
  • Experience reviewing and responding to ADT data from health plans is preferred.
  • Certified Medical Assistant certification is preferred.

About the Company

CareSource

Member-first health plan: Marketplace, Medicare, Medicaid

CareSource provides health coverage to more than 2 million members, offering Marketplace plans as well as Medicare and Medicaid products. Its core service is delivering health insurance and related care to individuals and communities through a member-first approach, aiming to improve health and well-being over time. The company operates with a focus on affordable, accessible coverage and care coordination across states, guided by its mission to place people over profits rather than simply selling plans. Key differentiators include a long history (30+ years), a national footprint with 4,500+ employees, and an emphasis on serving members’ needs and languages while promoting equal opportunity employment. The overarching goal is to help members live healthier lives by providing comprehensive coverage and support.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Dayton, OH
Founded
1989

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