Care Coordinator

The Care Coordinator is responsible for navigating the care management across the continuum of care of the member from acute to outpatient case management. The Coordinator, Care role is to incorporate administrative job functions to provide optimal care and coordination of care. The individual will assist with both the Inpatient (Acute/Skilled) and case management team in care coordination during the transition of care levels. They will work closely with members in promoting wellness and helping members in achieving optimal care during transition from Acute/Skilled settings to an outpatient basis. They will be responsible for developing relationships with members and providing support, encouragement, and health education. Responsibilities include but are not limited to assisting in scheduling medical appointments, durable medical equipment, home health, eligibility/benefit verification, requesting medical records, data entry, and review of medical management reports. A. Essential Duties and Responsibilities include the following: 1. Ability to remain positive in a fast paced environment. 2. Documents clearly and concisely in members file using directed documentation style. 3. Ability to time manage in a high work environment. 4. Follow process protocols efficiently and report any areas of process improvement to leadership. 5. Adaptability to consistent process changes. 6. Strong organizational and multi-tasking abilities. 7. Able to use system resources to increase productivity and organization. 8. Ability to recognize when they need assistance 9. Dependability and reliability 10. Timeliness 11. Welcome constructive criticism as an opportunity to learn and grow 12. Communicate in a clear and concise manner 13. Follow best practices email etiquette 14. Ability to use chain of command when issues arise 15. Coming up with innovative solutions and proposals to leadership 16. Ability to use critical thinking 17. Demonstrate integrity and character in the face of overwhelming challenges 18. Ability to take responsibility over member and tasks and resolving issues timely 19. Responsible for contacting members to provide necessary wellness coaching to improve self-management skills and enhance patient provider communication. 20. Anticipate our customer needs: Understand the wants and needs of customers, listen for cues and identify how to respond and what level of intervention they need. 21. Greets patients, family members, and physicians in a positive manner by introducing self, speaking clearly and with confidence. 22. Returns phone calls to customers and follows up with requests. 23. Ability to maintain high call volume; incoming and outgoing calls 24. Assists other staff and supports the team approach. 25. Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner. 26. Demonstrates honesty and integrity in everyday activities. 27. Protects privacy for both patients and employees; ensures all personal health information is kept confidential i.e., (sensitive papers, charts, and reports are not in view of the public). 28. Recognizes when an error has been made and immediately reports to appropriate manager. 29. Participates in "service recovery" through follow-up with an upset customer, gathering information, and demonstrates empathy. 30. Functions as liaison between care managers, patients, physicians, and other healthcare providers. 31. Communicates appropriately and clearly to management, co-workers, and physicians. 32. Assists team with arranging services such as home health, DME, physician appointments, specialist appointments, and transportation. 33. Follows up with members to ensure arranged services are received. 34. Identifies members from daily discharged list that have been admitted to a facility and coordinate the discharge plan. 35. Requests admission and discharge records for coordination of care. 36. Notifies providers of patients' admission and health status and verifies patient follows up post discharge. 37. Follows post discharged members from acute and SNF settings and assist in implementing discharge plans 38. Checks eligibility and benefits. 39. Processes referral authorization based on Discharge Plans and ordered sent by Case Manager and or Physician. 40. Maintains turnaround time compliance in all aspects of the referral authorization process. 41. Demonstrates outstanding customer service skills with a can-do attitude. 42. Interacts professionally with other healthcare service providers. 43. Consults other departments as appropriate to provide services to member's needs. 44. Participates in the efficient, effective, and responsible use of resources such as supplies and equipment. 45. Maintains all reference material that is provided by the supervisor, manager or director. 46. Knows and follows the Employee Handbook policies and procedures. 47. Demonstrates the ability to follow through with requests, sharing of critical information, and getting to the individuals in a timely manner. 48. Maintaining Tracking logs accurately and timely 49. Participate in on-going training and in-services as needed. 50. Excellent documentation skills and able to work independently. 51. Willing to work to full capacity of experience and /or licensure under minimal supervision. 52. Open to constructive suggestions. 53. Able to function fluidly and adapt to rapidly changing work environment. 54. Performs other duties as directed by management. Education and/or Experience: 1. High school graduate required 2. Associates or Bachelor preferred 3. Medical Assistant certification preferred 4. Experience with HMO, Medicare, and or Medi-Cal. 5. 2 years of healthcare and Managed Care experience required 6. Knowledge of computers, faxes, printers and all other equipment. 7. Proficient in MS office programs: Excel, Word, Power Point, Access and Outlook. 8. Typing 30 WPM with accuracy. 9. Ability to deal with responsibility with confidential matters. 10. Ability to work in a multi-task, high stress environment. 11. Flexible and adapts to process change 12. Medical terminology, ICD10, and HCPC coding 13. Strong Customer Service skills and phone etiquette. 14. Conflict Resolution Experience 15. Critical Thinking 16. Strong analytical skills with the ability to organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success. Full Time Position Benefits: The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life. Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options. Health and Wellness: * Employer-paid comprehensive medical, pharmacy, and dental for employees * Vision insurance * Zero co-payments for employed physician office visits * Flexible Spending Account (FSA) * Employer-Paid Life Insurance * Employee Assistance Program (EAP) Savings and Retirement: * 401k Retirement Savings Plan * Income Protection Insurance Other Benefits: * Paid Time Off (PTO) * Company celebrations * Employee Assistance Program * Business-casual working environment * Sick days * Paid holidays * Mileage Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

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