Description
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.
DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all.
Job Description:
Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK.
** Candidate must reside in the state of Oregon.
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.
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 CCOs
Contacting 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 equivalent
6+ 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 designation
2+ years of experience working in a call center environment.
Experience in a dental/medical insurance setting.
Salary:
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 are dedicated to creating a work environment where everyone is rewarded for their contributions.
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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work® Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email thebrightside@sunlife.com to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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