Case Management Coordinator

4 weeks ago

Downers Grove, United States Duly Healthcare Full time

Overview

Case Management Coordinator - Full-Time, 40 hours per week Good enough isn’t for us. Duly Health and Care’s team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our work. Duly Health and Care works to understand what matters most to you. We recruit and retain team members who share a relentless passion and pride for helping others live happier and healthier lives. We invest in helping our team members develop their talents in a way that is rich in personal meaning. We invite you to join us, fulfill your purpose and make your mark Holistic benefits designed to help our team members flourish in all aspects of their lives, including: Comprehensive medical and prescription drug benefits that include medical coverage at 100% (after deductible) when utilizing a Duly provider. $5,250 Tuition Reimbursement per year. 40 hours paid volunteer time off. A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact 12 Weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members. 401(k) Match Profit-sharing program

Responsibilities

Are you ready to challenge the expected to deliver the extraordinary? The Case Management Coordinator provides support to the Nurse Case Managers for Health Plan members enrolled in disease management and case management programs. The Coordinator is responsible for data tracking, data analysis, reporting, and submission of required documents to the Health Plans to ensure compliance with payer Case Management delegation and CMS requirements. This role also assists in making outreach calls to members to conduct HRAs, appointment scheduling, mailings, etc. The Journeys and Adventures that Await Maintains all internal data and reporting for Case Management team within the UM Department, including but not limited to:

Validating monthly member reports to identify potential members for Complex Case Management, Case Management, and Disease Management services. Tracking active case management and disease management census on the designated logs. Providing assistance with outcomes reporting to quantify the impact of case management services on member population health. Logging weekly productivity of Case Management staff by payer and client. Coordinating other special case management projects and data collection and analysis as needed.

Assists the Nurse Case Managers in:

Preparing monthly Clarity and other Case Management reports. Compiling discharge lists for post dc follow up calls. Making outreach calls to complete Health Risk Assessment tools and conducts initial interviews to evaluate members' eligibility and needs. Referring identified cases to the Nurse Case Manager for follow up.

Provides member outreach support to CM/DM members by:

Overseeing mailings of introductory letters and resources as needed. Compiling and updating written and electronic resources. Responding to inquiries on the designated case management phone line. Serving as point of contact for MXO Tech Case Management and other IPA portals as needed. May assist in the processing of ambulatory referrals to meet member needs as directed by Case Management Nurses. Provides clerical support to the Case Managers, including faxing, mailing, obtaining medical records from portals, document preparation as needed.

Qualifications

The Experiences You Bring Associate's degree in Health Care, Business, or a related field preferred. 3+ years of experience working in a Managed Care, Case Management, or Medical Office enviornment preferred.

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