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The Care Advocate position, located in Columbia, SC, is a work-from-home position with occasional travel required.

Mileage is reimbursed. 

Position Summary:

This is a work-from-home position which requires residency in the State of South Carolina. The Care Advocate is a non-clinical position that assists the clinical staff in supporting members on the Medically Complex Children's Waiver (MCCW) program in South Carolina.

Essential Duties and Responsibilities: 

• Serves as an advocate to the member and their authorized representative, providing support, triage, and referral access to the clinical staff
• Participates in all client specific programs, process, and quality training programs
• Documents information into the SCDHHS electronic health record for all contacts with members and/or their authorized representative, doctors' office staff, or other stakeholders.
• Places outreach calls to members and/or their authorized representative for coordination, scheduling, collecting demographic, non-clinical information, referrals, DME requests, and other ancillary provider requests, as needed or requested.
• Provides outreach and scheduling support for member-specific missed appointments and assists care coordinators with confirming scheduled visits.
• Answers incoming service-related calls
• Applies logical problem-solving in daily tasks and maintains a positive, professional, and respectful attitude
• Works with clinical staff in the performance of all non-clinical/administrative tasks
• associated with the MCCW program
• Will have access and manage PHI in accordance with federal and state requirements (HIPAA, HITECH)

Supervisory Responsibilities  - NA

• Strong organizational and interpersonal skills
• Excellent written and verbal communication skills
• Detail oriented
• Ability to multi-task and work independently.
• Strong competency in Microsoft Office products including Word and Excel

Other ResponsibilitiesThis job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change at any time with or without notice.

• Adheres to the policies and procedures of Community Health Solutions
• Maintains strict confidentiality of client, company, and personnel information
• Demonstrates a strong commitment to the mission and values of the organization

• Adheres to company attendance standards
• Performs other duties as assigned by the Director of Care Advocate Programs
• Completes all annual training assigned by the deadline for completion
• Will demonstrate successful completion and compliance with all policies and procedures, to be assessed during quarterly performance reviews
• Criminal background, OIG, and South Carolina Exclusion list checks must remain in good standing.

Qualifications

• A high school diploma or equivalent is required.
• A minimum of two (2) years of work experience in a medical office setting.
• Knowledge of medical terminology is required.
• Proficiency in data entry skills
• Strong customer service/telephone skills
• Medicaid experience a plus Bilingual (Spanish) preferred

Certificates, Licenses, Registrations (Preferred)Certified Medical Assistant, Certified Community Health Workers

Computer SkillsDemonstrated computer proficiency with Microsoft Office, electronic health record (EHR/EMR) systems, Medicaid documentation and care management platforms, and the ability to efficiently navigate multiple electronic systems while maintaining accurate, timely, and compliant clinical documentation in accordance with state and regulatory requirements.

Environmental Factors/Physical Demands:

This position is performed from a remote home office. The employee is responsible for maintaining a professional, safe, and secure home workspace with reliable high-speed internet access that supports the secure handling of confidential and protected health information (PHI). Employees are responsible for providing and maintaining their own home office furniture and workspace.

While performing the essential functions of this position, the employee will regularly use a computer, telephone, and other office equipment; communicate with patients, caregivers, providers, and team members through various electronic platforms; and enter, retrieve, and maintain information in multiple electronic health record (EHR) and Medicaid documentation systems. The position requires prolonged periods of sitting, keyboarding, and viewing computer monitors.

The position may require standing, walking, bending, reaching, kneeling, stooping, and lifting or carrying materials and equipment weighing up to thirty (30) pounds. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position.

HIPAA and Data Privacy ObligationsDue to the nature of this position and its involvement with the Medically Complex Children's Waiver Program, you will have access to Protected Health Information (PHI) governed by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state privacy laws.

• This role has direct access to Protected Health Information (PHI). The following rules are non-negotiable:Absolute confidentiality: Employees must not disclose PHI to unauthorized individuals under any circumstances.
• Secure environment: A private, locked workspace must be maintained to prevent exposure of PHI to family members, visitors, or others.
• Company-approved technology only: All work must be performed on secure, company-issued devices using encrypted connections (VPN required).

You will be required to complete HIPAA training upon hire and annually thereafter. Any breach of confidentiality or unauthorized disclosure of patient information may result in disciplinary action up to and including termination and may carry legal consequences under state or federal law.

Remote / Hybrid / Flexible Work Requirements

Employees working remotely and accessing Company systems or Protected Health Information (PHI) must meet the following minimum requirements:

• Reliable, high-speed internet service capable of supporting Company applications and video meetings.
• Hotspots, public Wi-Fi, or unsecured wireless networks are not permitted while performing work involving Company systems or PHI.
• A private, secure workspace where confidential conversations and information cannot be viewed or overheard by unauthorized individuals.
• Ability to maintain compliance with all HIPAA, Company confidentiality, and information security policies.
• Company-issued computer and equipment must be used for all Company business unless otherwise authorized in writing.
• The remote workspace must be password protected and physically secure when unattended.
• Employees must lock their computer whenever stepping away from their workstation.
• Printed documents containing PHI should be avoided whenever possible. If printing is necessary, documents must be secured and properly destroyed using an approved shredder or secure disposal method.
• Family members, roommates, visitors, or other unauthorized individuals may not access Company equipment, systems, or confidential information.
• Employees must immediately report any lost, stolen, or compromised equipment, passwords, or suspected security incidents.
• Employees must comply with all Company cybersecurity requirements, including multi-factor authentication (MFA), password standards, software updates, and antivirus protection.
• Employees are responsible for maintaining a workspace that is safe, free from distractions, and suitable for productive work during scheduled working hours.
• Employees must be available during their scheduled work hours and maintain regular communication with supervisors and team members.

The Company reserves the right to inspect or request photographs of the remote workspace for purposes of verifying compliance with security, confidentiality, safety, and equipment requirements, when permitted by law and with reasonable notice.

Please note that employment in South Carolina is at-will, and either you or CHS may terminate the employment relationship at any time, with or without cause or notice. Nothing in this letter creates a contract for continued employment.

Premier Family of Companies and its affiliates is committed to providing a safe, healthy, and productive work environment for all employees. To achieve this, CHS maintains a smoke-free and drug-free workplace. Candidates who receive a conditional offer must complete a pre-employment drug screen. Random and post-incident testing may also be required.

You agree to maintain the confidentiality of all proprietary and non-public information obtained during your employment. This includes, but is not limited to, company records, financial data, client and vendor information, business strategies, and any other information not generally known outside the Company. You may not use or disclose such information during or after your employment, except as required in the performance of your duties. All company property and materials must be returned upon separation of employment.