Job description
Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org .
Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
Summary:
We are searching for a Case Management Assistant to assist the Case Manager in the identification of member needs, initiation of member contact, provision of member and provider education and coordination of community resources to promote optimal health.
Think you've got what it takes?
Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children's, unless approved for a medical or religious exemption.
- High school diploma or GED required
- Two years of experience in Case management, community outreach, healthcare, and/or health insurance experience OR
- Three years of general administrative experience required
- Two years of call/contact center experience preferred
- Provides Support for Case Management Services.
- Initiates member phone calls daily and identifies issues and refers to Case Managers and other health plan departments as indicated.
- Documents in current case management system.
- Responsible for ongoing analysis of claims data to identify needs for quality/performance
- Screens and evaluates all calls and refers as necessary to Case Manager, Social Worker, or Transition Specialist and/or supervisor.
- Completes all eligibility and benefit data available on members before routing to Case Manager or Transition Specialist.
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