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Care Coordinator | Low Desert
3 months ago
Job Summary: The Care Coordinator is responsible for assisting members and their families in obtaining and understanding services and programs available through the Enhanced Care Management Program to improve their health and overall well-being.
Position Responsibilities:
- The Care Coordinator/Housing Coordinator provides care coordination and connection to services and social support for ECM Members, including appointment scheduling and referral
- Provides on-going monitoring of the Targeted Engagement List (TEL).
- Assigns Members to the appropriate ECM Care Team members based on risk category and available clinical data for ECM engagement
- Responsible for primarily working with a caseload of Members identified as being low
- Conducts periodic telephonic outreach and follow-up to low-risk ECM Members as outlined on the Shared Care
- Supports RN Care Manager, BH Care Manager and Community Health Worker with delegated
- Assists in the coordination of appointments and referrals for physical and behavioral health
- Collaborates on Member care issues with other ECM Care Team Members, participating in weekly systematic case reviews and ad hoc case reviews, and consults with Registered Nurse Care Manager and/or the Behavioral Health Care Manager before taking any action that is clinical in
- Connects ECM Member to other social services and supports he/she may
- Uses relationship-based strategies to engage Members in care as well as motivational
- Assists with arrangements such as transportation, directions, and completion of durable medical equipment requests, Coordinates with ECM Member in the most easily accessible setting, within health plan guidelines (e.g., could be patient home, provider or regional office, or other setting)
- Reviews data and interviews potential members to verify eligibility for enrollment in the Enhanced Care Management Program (ECM) and completes referral process when
- Orients and educates members and their families by meeting with them to explain the role of the Care Coordinator, initiate a care plan, and provide educational information related to treatments, procedures, medications, and continuing care requirements in coordination with their healthcare
- Documents evidence of care in the member’s record in a concise and timely manner using the EHR
- Addresses member questions and processes member requests in a timely
- Investigates and directs member inquiries or complaints to appropriate staff members and follows up to ensure satisfactory
- Recognizes signs of child and elder abuse and reports appropriately to Child/Adult Protective
- Understands and abides by all departmental and companywide policies and Performs other duties as assigned or required.
Position Requirements:
- Education & Experience: High School Diploma +1 year of experience as a medical assistant, healthcare tech, certified nursing assistant, home health, hospice, care management, or any other healthcare field. Equivalent combination of education and experience that provides the skills, knowledge, and ability to perform the essential job duties, and which meets any required state or federal certification requirements.
- Language: Fluent in English (written and verbal). Bilingual preferred.
- License/certification: Current and valid Driver’s License and proof of auto insurance.
- Skills required:
- Competent with computers, email, virtual platforms, Excel, and other Microsoft Office based programs.
- Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear, effective manner.
- Ability to identify problems and use logic and related information to develop and implement solutions.
- Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures.
Physical Requirements: Physical demands associated with office work and driving, including but not limited to:
- Consistently operating a computer and other office equipment such as a telephone, calculator, copy machine, and printer.
- Must be able to remain in a stationary position 75% of the time.
- Must be able to move around the office or community 50% of the time.
- Frequently moving or carrying office equipment weighing up to 15 pounds across offices.
- Ability to operate a vehicle and travel to meet with assigned members around the community, attend meetings and different office locations as required or requested.
