EXL (NASDAQ: EXLS) is a leading operations management and analytics company that designs and enables agile, customer-centric operating models to help clients improve their revenue growth and profitability. Our delivery model provides market-leading business outcomes using EXL’s proprietary Business EXLerator Framework™, cutting-edge analytics, digital transformation and domain expertise. At EXL, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and compliance. EXL serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industries. Headquartered in New York, New York, EXL has more than 26,000 professionals in locations throughout the United States, Europe, Asia (primarily India and Philippines), South America, Australia and South Africa. For more information, visit www.exlservice.com.
JOB SUMMARY: This position has advanced support duties within the Synergy department and performs a variety of duties related to coordination of services for Synergy participants including but not limited to:
• Identifies local community resources available to support members with achieving condition self-management and to facilitate member access to those resources
• Development and maintenance of a resource catalog per client, based on the benefit structure, per health condition, and by the types of social service and other resources available within the community
• Manages the external resource research report per client under the direct supervision of the Synergy Management Team to assure external referrals are documented upon receipt and are acted upon in a timely manner.
• Assists the department staff in ensuring that member needs are coordinated, tracked, and documented.
• Assists in preparing cases for monthly Care Coordination meetings, in conjunction with the Supervisors and Manager
• Assists in referrals of members to customer medical management services or to HI medical management services as appropriate
• Acts as liaison to Members, Providers, Customer Service Representatives, Outreach Coordinators, Personal Clinicians and Client Representatives in the coordination of care for Synergy members in order to facilitate member self-management with ultimate improved member outcomes
Shift: Monday- Friday 11:30am-8pm
• Promotes working relationships that support success of Synergy members based on care plan recommendations;
• Assist Synergy management in handling escalated member and provider situations.
• Identifies and promotes training opportunities for the staff, serving as a resource professional and training of the staff when applicable. .
• Has and maintains a clear and precise understanding of non-clinical responsibilities/functions and directs all clinical issues to clinicians as needed.
• Becomes knowledgeable of all Health Plans and Health Integrated specific client information and consistently maintains that knowledge base. This is a key component of staff support.
• Assist as needed, in monitoring and backing up the Synergy queues.
• Act as delegated point of contact for the Interdepartmental/Internal Referral process.
• Identify resources for External Referrals across plans as needed.
• Follow up on completion status of MD Consults.
• Maintain and coordinate the library of support resources
• Communicates appropriately and according to corporate policies and/or regulatory requirements with the practitioner(s), and/or facilities(s);
• Other duties as required
• Supports a positive working environment;
• Maintains a courteous and professional attitude when working with all HI staff members and the management team;
• Actively participates in team meeting
• Works well with all departments within HI to communicate/resolve internal issues.
• Maintain the accurate and updated status of all programs/projects/activities for the team
• Track and ensure positive forward progress is being made on all projects/activities on a regular basis
• Elevate and escalate projects/activities which are in jeopardy or fall behind
• Provide regular reporting on projects/activities
• Prepare non-clinical reports as required by the business
• Create formal report requests when appropriate
• Gather reporting data for succinct reporting and discussion
• Assist with non-clinical documents for audits for clients as required
• Send secure clinical alerts and faxes
• Support Management and Team initiatives
• Contact members to reschedule appointments due to staff unavailability
• Assist with non-clinical aspect of crisis calls
• Other duties as required
Education/License/Certification: High school diploma/ GED or equivalent relevant work experience in the area of care coordination or case management services.
Experience: One-year prior social service care coordination or case management experience preferred. Prior experience in medical/behavioral health field required.
•Excellent verbal communication skills are required in order to effectively promote program services and coordinate services with participants
• Ability to handle detail-oriented work with good problem-solving skills.
• Strong research and assessment skills
• Strong interpersonal skills with capacity to project warmth and empathy
• Ability to independently prioritize workload
• Effective listening and organizational skills
• Ability to use multiple computer applications (i.e. database, word-processing) and ACD telephone system
• Ability to work effectively with coordination of member services with Synergy members, Personal Clinicians, and clients as necessary
• Must be flexible, willing to accept changes occurring in a dynamic environment.