Hello, we’re Belong.
We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products.
With a dual focus on data-driven, proactive clinical intervention and unwaveringly empathetic patient experience, Belong has completely reimagined health insurance for seniors and other Medicare-eligible individuals who have been disregarded and deprioritized for far too long.
We believe that only by recognizing individuals can we make communities strong.
Belong Health. Kinder, more supportive care.
Why do we exist?
Belong Health was created to bring a high-quality, seamless customer experience to vulnerable Americans with complex health needs. We believe that all Americans deserve an opportunity for optimal health, and we understand that health is related to many factors outside of traditional healthcare. We are dedicated to a vision of the future where holistic health incorporates data and technology into a humanistic and behaviorally sophisticated model of care.
What do we do?
Belong Health is a partner platform launch- built-for-purpose, technology-enabled healthcare organizations. They aggregate the leading talent in the market to solve specific problems in healthcare that improve the lives of patients and lead the industry towards a more rational, sustainable, and humane model of care. Belong Health partners with regional health plans to deliver best-in-class Medicare Advantage (MA) and Specials Needs Plan (SNP) products, creating new opportunities for organic growth that enable better service for their existing membership.
How do we do it?
Belong Health provides the services and funding to launch a new health plan: Belong Health works with regional health plans to understand their relative market position & operational strengths, create specific strategies that deliver MA / SNP membership, and launch complementary but distinct new plans together.
Where do I fit in?
The Community Services Care Coordinator (CSCC) will work directly with members, members’ families and/or advocates, providers, and community service organizations to ensure that members have access to the range of supportive services needed to promote quality of life and the achievement of member identified desired outcomes. The CSCC is responsible to address the needs and wishes of the member and his or her family and/or advocate and to support changes as they affect the member’s desired outcomes, quality of care and quality of life. The CSCC will empower the member to make informed decisions and advocate on their behalf when deemed necessary.
The CSCC will assist the Leader, DSNP RN Care Manager (RNCM) in identifying, developing, and implementing the individual care plan (ICP) and assist members in reducing/resolving challenges or barriers so that the member may achieve their optimal level of health, independence, safety, and well-being.
The CSCC will educate the member, family and/or primary caregiver regarding plan benefits, identify and arrange needed social and health support services, conduct in-home visits, and follow-up with the member and his/her designee on an ongoing basis.
The position will cover a broad territory in New York and will support members in their homes, at work, or day programs as necessary. The CSCC will develop and maintain a collaborative relationship with community-based resources, the Belong Network Development team and Product Development
SCOPE OF RESPONSIBILITIES
As a Community Services Care Coordinator (CSCC) you will:
- Orient new members to the Belong Health DSNP program.
- Provide on-going support to members related to the coordination of and access to services, grievances, and appeals, claims inquiry, social services etc.
- Meet with physician representatives to identify member health needs as necessary.
- Work with internal Belong Health DSNP staff to resolve member issues around billing, service denials, payment, authorization, interaction, appeals, grievances and other member issues.
- Ensure complete communication feedback to/from members regarding problem resolution, product design, and member eligibility, other post-enrollment activities, etc.
- Ensure compliance with CQL measures and standards.
- Familiarize member with appropriate member communication materials, including evidence of coverage, network directories and other materials as necessary.
- Ensure accurate and updated member information and communication on Belong Health website.
- Facilitating and monitoring the implementation of the member care plan in accordance with recommendations by the Interdisciplinary Care Team and ensuring accurate and timely authorization.
- This position has a broad range of on and off call responsibilities. On call responsibilities include responding to customer inquiries in areas of enrollment, billing, claims, benefit interpretation, and referrals/authorizations for medical care. Other on call duties include Help Desk support and the handling of escalated issues (calls). Off call work may include service issue research and resolution, reporting, special projects, assist with training, facilitating, and attending meetings, walk-in coordinator duties on a back-up basis as needed, etc.
- Promote a culture of accountability and performance to both meet and exceed personal service vision goals and ensure timely and satisfactory resolution of highly complex, specialized, and non-routine customer issues
Follow-through on commitments. Lives up to verbal and written agreements, regardless of personal cost.
Attention to detail. Does not let important details slip through the cracks or derail a project.
Persistence. Demonstrates tenacity and willingness to go the distance to get something done.
Proactivity. Acts without being told what to do. Brings new ideas to the team. Creativity/innovation. Generates new and innovative solutions to problems.
Enthusiasm - Exhibits passion and excitement over work. Has a can-do attitude.
Listening skills - Lets others speak and seeks to understand their viewpoints. Communication - Speaks and writes clearly and articulately without being overly verbose or talkative. Maintains this standard in all forms of written communication, including e-mail. Teamwork. Reaches out to peers and cooperates with supervisors to establish and overall collaborative working relationship.
ON-TIME - Someone who respects other people’s time, efficient with time, completes tasks on time, speaks up if the time expectations are not realistic.
ACCOUNTABLE - Someone who consistently does what they say they are going to do when they say they are going to do it.
ACTIVE PARTNER - Someone who is a proactive team member, willing to jump in and lend a hand without being specifically asked to do so.
- Valid New York State driver’s license
- Working knowledge of Medicare and Medicaid programs and experience with regulatory requirements and reporting.
- Knowledge of managed care and / or member services.
- Knowledge of community services and resources for elders and disabled.
- Familiarity with coordinated care models is an advantage.
- 2+ years’ experience in a customer service, health care organization, Community Based Organization, or social services environment.
- Demonstrated experience in a managed care or HMO setting is strongly preferred
- Three (3) to Five (5) years of progressively responsible in a high-volume call health care or social service related.
- Understanding of the needs and dynamics of elder care services, disadvantaged, disengaged populations.
- Experience in participating in cross departmental projects and policy and procedure changes, including coordination of activities and initiatives across departments.
- Demonstrated ability to work in a fast-paced, high volume call-center environment and manage staff to both meet and exceed goals and key performance measures.
- Passionate about customer service with a continuous improvement mindset.
- Excellent problem solving, trend identification, and analytical skills, with a demonstrated ability to problem solve effectively and efficiently.
- Commitment to high ethical standards in all work; protects the privacy of member and Belong data and exercises discretion in handling confidential member information.
- Excellent oral and written communication skills, including presentation skills.
- Demonstrated PC skills using Microsoft applications.
- Must be able to travel to other office locations, as necessary.
- Must be able to work flexible schedule.
- In depth knowledge of managed care product portfolio, benefits, policies and procedures.
- Strong active listening, issue assessment and problem-solving skills.
- Strong organizational and follow through skills.
- Ability to exercise discretion in handling confidential member information.
- Passion for customer service and process improvement.
- Self-direct individual.
- Office work; may be sitting for long periods of time.
- Some travel may be required.
- Ability to work independently and maintain flexibly in fast paced start up environment.
- Must have access to reliable daily transportation.
- Superior knowledge of healthcare products and services.
- Bachelor’s degree in social / health sciences or business
- Bilingual (Spanish) a plus.
Belong Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.