Care Coordinator; reside in Oregon

Position: Care Coordinator (Must reside in Oregon)
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

At Sun Life, we're driven by our

Purpose:

helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.

When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Job Description:

The opportunity:

The Care Coordinator is responsible for telephone outreach to designated member populations to ensure retention, utilization of services, and satisfaction as well as meeting compliance regulations with reporting on these topics. Must reside in Oregon.

How you will contribute:

Assist with care coordination of members with special health care needs as designated by Coordinated Care Organizations (CCOs), the Oregon Health Authority (OHA), members, members’ caregiver or their representative. This includes, but is not limited to:

Contacting and counseling members in regards to emergency department usage for dental related reasons as reported through company’s secure connect to the Emergency Department Information Exchange (EDIE) or directly from hospitals and CCOsContacting and counseling members in regards to missing dental appointments as reported by primary care dental offices (PCDs)
Assisting in the reassignment of dismissed of members from their current PCD and coordinating success care in the future for the member; escalating to a Care Coordinator, Advanced when necessary

Coordinating care for members needing additional services in a dental practice after being seen in a community setting

Community Partner Requests for assistance through Health Risk Screening Processing medical to dental referrals to care Processing of Pilot projects referrals to care Ensure all documentation is entered accurately and timely into all case management systems for continuity of care purposes

Assist in improving the region’s health by considering each community member’s unique health, cultural and social needs

Other duties as needed or required

What you will bring with you:

Required:

High school diploma or equivalent6+ months of experience working with Medicaid populations by phone or in person, or equivalent

Computer proficiency in a variety of Windows applications

Attends additional training as requested/deemed necessary

Preferred:

Certification as a Community Health Worker or other Traditional Health Worker designation2+ years of experience working in a call center environment.

Experience in a dental/medical insurance setting.

PHYSICAL DEMANDS:

Incumbent must be able to communicate effectively.

Requires overall light physical effort (up to 25lbs.)Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal compute).Ability to travel or move about within and outside serviced facilities required.

Incumbent works primarily in either a private or shared office environment.

Salary Range: $40,600 - $54,800

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business.

We…