Member Services Coordinator

Condition Management Account Coordinator Location : Onsite in Dubuque, IA. Also accepting remote applicants. HealthCheck360 has an immediate opening for driven, energetic, and customer focused candidates for our Condition Management Account Coordinator role. In this role, you will answer inbound calls from our participants along with making outbound telephonic calls to participants enrolled in the Condition Management Program. And the best part? You don't need experience - we will train you! We are seeking individuals with strong customer service skills that can perform well individually and in a team environment. This role is perfect for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, health coaches, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. We pride ourselves on putting the participants first and finding ways to improve our business. Above all else, we are committed to fostering an open door culture where the opinions and suggestion of our team members are valued and appreciated. Essential Functions: Answer participants inquiries Assist participants via email and online messaging Accurately document participant communications Specific Skills: Strong verbal and written skills Detail oriented Pay & Benefits Most Benefits start Day 1 Medical, Dental, Vision Insurance Flex Spending or HSA 401(k) with company match Profit-Sharing/ Defined Contribution (1-year waiting period) PTO/ Paid Holidays Company-paid ST and LT Disability Maternity Leave/ Parental Leave Subsidized Parking Company-paid Term Life/ Accidental Death Insurance About Cottingham and Butler’s Health and Wellness Division Cottingham and Butler’s Health and Wellness division was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing em

Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off , this is the role for you! The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. Y ou will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements. Preferred Skills Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans Qualifications: CNA, LPN, or Medical Assistant preferred Background in patient health support or care 1+ years of experience within this field Full-Time Benefits - Most benefits start day 1 Medical, Dental, Vision Insurance Flex Spending or HSA 401(k) with company match Profit-Sharing/Defined Contribution (1-year waiting period) PTO/Paid Holidays Company-paid ST and L

Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off , this is the role for you! The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. Y ou will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements. Preferred Skills Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans Qualifications: CNA, LPN, or Medical Assistant preferred Background in patient health support or care 1+ years of experience within this field Full-Time Benefits - Most benefits start day 1 Medical, Dental, Vision Insurance Flex Spending or HSA 401(k) with company match Profit-Sharing/Defined Contribution (1-year waiting period) PTO/Paid Holidays Company-paid ST and L

Member Service Coordinator Location: Davenport, IA (hybrid). What Our Member Service Coordinators Do and Why It’s Important: Member Service Coordinators play a key role in delivering our advocacy services, serving as a trusted resource for members as they navigate their employer benefits. In this role, you will help individuals understand their coverage, resolve issues, and connect them with the care and resources they need—ensuring a seamless experience through phone, email, and chat interactions. In addition, Member Service Coordinators support participants throughout their company’s wellness program by answering questions and assisting with a variety of program-related needs. We are seeking candidates who are confident guiding individuals through benefit questions and delivering a high-touch, supportive level of service. This role is a great fit for individuals with experience in roles such as receptionist, scheduler, insurance verification, or within a medical environment, as well as those with strong customer service skills who are looking to make a meaningful impact. Schedule: The standard work week for this position will be Monday through Friday, 8-5pm. Full-Time Benefits - Most benefits start day 1 Medical, Dental, Vision Insurance Flex Spending or HSA 401(k) with company match Profit-Sharing/Defined Contribution (1-year waiting period) PTO/Paid Holidays Company-paid ST and LT Disability Maternity Leave/Parental Leave Subsidized Parking Company-paid Term Life/Accidental Death Insurance About Cottingham and Butler’s Health and Wellness Division Cottingham and Butler’s Health and Wellness division was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted commu

Become a part of our caring community The Field Service Coordinator (Care Coach 1) assesses and evaluates member's needs and requirements. This is done to achieve and/or maintain optimal wellness state by guiding members/families toward resources appropriate for their care and wellbeing. The Service Coordinator work assignments are often straightforward and of moderate complexity. Your role will involve meeting members in their location, spending quality time assessing their needs and barriers and then connecting our members with quality services to promote their ultimate well-being and guide health outcomes. Responsibilities include: Administer ongoing long-term services and support (LTSS) related assessments through person-centered thinking approaches. Contacts members both telephonically and/or in-person to establish goals and priorities. This involves evaluating resources, developing a plan of care, and identifying LTSS providers and community partnerships. The goal is to provide a combination of services and supports that best meet the needs and goals of the member and caregiver through person-centered thinking approaches. Development and modification of Service Plan and involve applicable members of the care team in care planning (Informal caregiver coach, PCP) Support members through navigation of their LTSS and related environmental and social needs Use available information about member to prevent the need for administration of duplicative assessments. Focus on supporting members or caregivers in accessing long-term services and support, social, housing, educational and other services, regardless of funding sources to meet their needs. Assist members in maintaining Medicaid eligibility Collaborate with Medical Director/Geriatrician/Care Coordinator as deemed necessary to ensure cohesive, holist

Become a part of our caring community Humana Gold Plus Integrated is seeking a Senior Care Coordinator to evaluate member's needs and requirements to achieve and maintain an optimal wellness state by guiding members/families toward resources appropriate for their care and wellbeing. The Senior Care Coordinator work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Care Coordinator (SCC) will provide support to their manager by precepting, coaching, and mentoring team members. The SCC will assist in providing guidance, support, and development of processes utilized by the team as well as create supports and maintain a positive work environment. They will provide field work support to the team as needed and will monitor field work visits completed by team members. They will escalate issues to their manager as needed and support team management as requested. The Senior Care Coordinator Primary Roles & Responsibilities include: Provides coverage for Care Coordinator (CC) 1 and 2 and be able to document in the clinical system. Mentors and supports the team, as well as training initiatives. Provides daily reports to the Care Coordinators regarding outstanding cases and will review daily compliance dashboards. Supports audit initiatives and support any internal and external auditing processes for the team. Completes field work support and review reports. Supports new hire onboarding including but not limited to precepting and case audits. Coordinates services, monitors, and evaluates the case management plan against the member's personal goals. Ensures the patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversatio