| Location | Remote-FL, FL (Remote) |
Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan Communicate with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service May support performing service assessments/screenings for members and documenting the member s care needs Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards Ability to identify needs and make referrals to Care Manager, community-based organizations, and Disease Manager Provide education on benefits and resources available Performs other duties as assigned. Comply with all policies and standards. | ||||||
| Story Behind the Need | ||||||
| What is the purpose of the First Year of Life (FYOL) team? The FYOL team provides care coordination, member outreach, and education to support infants and their caregivers during the first years of life.
This request is being driven by ongoing business and operational needs to support FYOL program growth, maintain outreach and engagement requirements, manage caseload volumes, and ensure timely completion of assessments, care coordination activities, and program deliverables.
The FYOL team operates in a fully remote environment and is part of the broader SHP Maternity program or the Family Planning Services Care Management team
Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative? Currently, this request is intended to support current FYOL operational and workload needs. It is not part of a larger hiring initiative; however, future staffing needs will continue to be evaluated based on program growth, business demands, membership volume, and operational requirements. | |||||
| Typical Day in the Role | ||||||
| Day-to-day responsibilities The contingent worker will support the FYOL Program by conducting member outreach to parent/Client/caregiver, engaging eligible members and caregivers, completing assessments, providing health education, coordinating care, and connecting families to available plan benefits and community resources. Daily activities include managing assigned caseloads, documenting member interactions, supporting referral processes, monitoring outreach and engagement activities, assisting with care gap closure efforts, and collaborating with internal and external partners. The role supports the FYOL program's goal of improving infant health outcomes, promoting preventive care, and enhancing member engagement during the first years of life. Performance expectations Timely completion of member outreach and engagement activities. Completion of required FYOL assessments and documentation within established timeframes. Achievement of productivity and caseload management expectations. Accurate and compliant documentation. Timely follow-up on referrals, care coordination needs, and identified barriers. Support of quality improvement initiatives, preventive care measures, and member engagement goals. Adherence to departmental policies, workflows, and compliance requirements. Role This role focuses on supporting low risk infants and their caregivers during the period of growth and development. The position combines care coordination, member education, outreach, and social support services to improve health outcomes and address barriers to care. Team members work collaboratively across multiple programs and disciplines while helping families navigate healthcare services, preventive care, developmental milestones, and community resources. The role directly contributes to improving infant health, member experience, and health equity outcomes within the population served. | |||||
| Candidate Requirements | ||||||
| Education/Certification | Required: High school diploma | Preferred: Medical Assistant / Peds background | ||||
| Licensure | Required: None | Preferred: | ||||
| Years of experience required: " Experience in care coordination, case management, member services, population health, maternal-child health, pediatrics, Medicaid, or managed care. " Experience conducting telephonic outreach and engaging hard-to-reach populations. " Experience educating members on health benefits, preventive care, and available resources. " Familiarity with social determinants of health, resource navigation, and community-based services. " Experience working with infants, children, pregnant members, postpartum members, and/or families is highly desirable. " Experience utilizing care management platforms and documenting member interactions in electronic system " Proficiency with Microsoft Office applications, including Outlook, Teams, Word, and Excel. Disqualifiers: No experience managing peds populations or coordinating care Inability to work independently in a remote environment Limited computer proficiency or difficulty navigating multiple systems simultaneously Poor documentation, time management, or organizational skills No experience conducting telephonic member outreach and engagement (preferred for experienced candidates) Additional qualities to look for:
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| 1 | Proficient with computer skills and able to build on current skills | ||||
| 2 | Strong member engagement and relationship-building skills with the ability to build trust and rapport with caregivers and families | |||||
| 3 | Passion for improving infant and family health outcomes through outreach, education, and care coordination | |||||
| Candidate Review & Selection | ||||||
| Projected Manager Candidate Review Date: | 1-2 days post shortlisting | ||||
Type of Interviews: Teams, phone, etc.? | Teams interview | |||||
| Required Testing or Assessment (by Vendor): Typing test, basic computers skills test, etc.? | Computer skills test or assessment | |||||