Sun Life · 8 hours ago
Sr. Care Coordinator, DentaQuest
DQ Milwaukee Bayshore
Full-time
Hybrid
Mid, Senior Level
$54K/yr - $73K/yr
2+ years expSun 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. The Care Coordinator role involves supporting members with special healthcare needs, coordinating care services, and ensuring documentation for continuity of care is maintained.
FinanceFinancial ServicesInsurance
Responsibilities
Intensive Needs Care Coordination as required by contract with Coordinated Care Organizations (CCOs) and the Oregon Health Authority (OHA) providing targeting services to members with special physical, mental, environmental or age-related needs
Research and resolve all Case Management requests received from the Provider Network in regard to behavior, fraudulent, or special healthcare needs that cannot be met in the office setting
Out of Network service arrangements with out of network providers based on organization’s policies
In Area, Out of Network service arrangements with local out of network providers in order to provide local specialized treatment where needed based on organization’s policies
Coordinate with CCO’s, Resource Parents and providers to ensure all DHS Foster children are seen in a timely manner
Processing of items needing additional coordination, such as:
O Member request for assistance through a Health Risk Screening
O Processing of Second Opinion requests from members
O Processing of Tribal Health Referrals
O Processing Permanent Referral Requests from PCDs
Assist with care coordination of members with special health care needs as designated by CCO, OHA, members, members’ caregiver or representative. This includes, but is not limited to:
O Engaging foster parents in assessments for members in foster care as reported by the CCO
O Initiating care for members that are indicated as residing in care facilities or those with social determinants of health (SDoH) as indicated by the CCO
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
Qualification
Required
High school diploma or equivalent
2+ years of experience working with Medicaid populations by phone or in person; knowledge of Oregon Medicaid highly preferred
6+ months of experience working in an entry level Care Coordinator or Case Manager position (or equivalent)
Computer proficiency in a variety of Windows applications
Attends additional training as requested/deemed necessary
Preferred
Experience with trauma informed care preferred
Certification as a Community Health Worker or other Traditional Health Worker designation
Associates or Bachelor's Degree in Social Work
Experience in a dental/medical insurance setting
Benefits
Generous vacation and sick time
Market-leading paid family, parental and adoption leave
Medical coverage
Company paid life and AD&D insurance
Disability programs
Partially paid sabbatical program
401(k) employer match
Stock purchase options
Employer-funded retirement account
Company
Sun Life
Sun Life is a leading financial services organization dedicated to helping people achieve lifetime financial security and live healthier lives.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$1.05B2024-05-13Post Ipo Debt· $548.79M
2023-07-04Post Ipo Debt· $500M
2000-03-24IPO
Leadership Team
Kevin Strain
President & CEO
Luc Nhon Ly
Chief Executive Officer
Recent News
2025-12-02
MarketScreener
2025-12-02
South China Morning Post
2025-11-27
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