Care Management Coordinator

Overview

Our Retail Pharmacy client is looking for a Care Management Coordinator to work directly with other coordinators to ensure quality of work delivered, performance/productivity benchmarks are met, and all compliance-related issues are properly addressed, trained and coached on a consistent basis. The perfect candidate will provide call center outreach to members related to referrals, gaps in care and services needed. Assist with appointment scheduling, transportation scheduling and referral assistance.

Responsibilities:

• Support comprehensive coordination of medical services including member transitions, screening and supporting the implementation of referrals to promote effective utilization of healthcare services. 
• Promotes/supports quality effectiveness of Healthcare Services. Create authorizations in QNXT to support continuity of care for member. 
• Screens incoming forms using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. 
• Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services
• Utilizes critical thinking and judgment to collaborate and inform the case management/concurrent review process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management/concurrent review tools and resources. Will assist with auth creation, appointment scheduling, and outreach to members, referral follow up.

Experience:

• Call center experience
• Preferred strong customer service skills
• Strong problem-solving and analytical skills
• Possess strong computer navigation skills
• Comfortable with regular feedback and development
• Works well in a team environment
• Must have basic medical terminology experience
• High school diploma or GED required, 1-2+ years of call center experience.

The target hiring compensation range for this role is $15.91 to $17.68 an hour. Compensation is based on several factors including, but not limited to education, relevant work experience, relevant certifications, and location.

About Aquent Talent:

Aquent Talent connects the best talent in marketing, creative, and design with the world’s biggest brands.

Our eligible talent get access to amazing benefits like subsidized health, vision, and dental plans, paid sick leave, and retirement plans with a match. We also offer free online training through Aquent Gymnasium. More information on our awesome benefits! 

Aquent is an equal-opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. We’re about creating an inclusive environment—one where different backgrounds, experiences, and perspectives are valued, and everyone can contribute, grow their careers, and thrive.