Care Management Coordinator I

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service.
We are proud to say that for three years, HMA has been chosen as a 'Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, 'Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.
What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven.
What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/
How YOU will make a Difference:
The Care Management Coordinator demonstrates the ability to independently assess and synthesize work inputs to determine the scope and function of the work to achieve the desired goal; works directly with project team leads to implement new functions; provides input for coordinating member support functions across the Care Team; assesses the needs of the business and forms recommendations in response to business growth. Care Management Coordinator provides ongoing operational support across the organization as needed.
What you will do:

• Consult and work with healthcare providers throughout the RGA network to coordinate care and review service denials
• Work independently to create provider and member-facing denial letters by crafting clear and concise sentences using medical director denial information, personal expertise, medical criteria, and nurse input and plan language
• Use autonomy to triage and analyze requests for Peer to Peer calls, disabled dependent determinations, medical travel benefit work and other member and provider needs to determine next steps and actions
• Provide direct member contact and coordination for care needs not limited to disabled dependents, medical travel, continuity of care, denials, P2P and appeals
• Work across departments and with external partners to coordinate care not limited to customer care, Care navigators, intake, utilization review, case management, medical claim review, appeals, COB, enrollment and compliance
• Assess barriers to a positive member experience and strive to bridge gaps
• Support and fill-in non-clinical duties as needed to support the function of the Care Team
• Work across departments and with external partners to coordinate care not limited to customer care, Care navigators, intake, utilization review, case management, medical claim review, appeals, COB, enrollment and compliance
• Assess barriers to a positive member experience and strive to bridge gaps
• Support and fill-in non-clinical duties as needed to support the function of the Care Team

Knowledge, Experience, and Key Attributes needed for Success:

• High School Diploma required
• 3-5 years of minimum health plan, clinical or community health experience
• Ability to communicate complex ideas
• Ability to interpret reporting and set a plan of action
• Ability triage and prioritize work
• The ability to problem-solve and use critical thinking skills
• Excellent, internal and external client-facing verbal and written communication skills
• Proficiency with Microsoft Office applications (Outlook, Word, DOSS)
• Self-motivated and self-directed
• Enjoys the pace and rhythm of a deadline-oriented environment with strong prioritization skill sets

Compensation:
The base salary range for this position in the greater Seattle area is $32.70/hr - $36.06/hr and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available.
Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.
In addition, HMA provides a generous total rewards package for full-time employees that includes:

• Seventeen (IC) days paid time off (individual contributors)
• Eleven paid holidays
• Two paid personal and one paid volunteer day
• Company-subsidized medical, dental, vision, and prescription insurance
• Company-paid disability, life, and AD&D insurances
• Voluntary insurances
• HSA and FSA pre-tax programs
• 401(k)-retirement plan with company match
• Annual $500 wellness incentive and a $600 wellness reimbursement
• Remote work and continuing education reimbursements
• Discount program
• Parental leave
• Up to $1,000 annual charitable giving match

How we Support your Work, Life, and Wellness Goals
At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party.
We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.)
HMA requires a background screen prior to employment.
Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures.
HMA is an Equal Opportunity Employer.
For more information about HMA, visit www.accesshma.com .