Member Care Coordinator

2 weeks ago

Springfield, United States w3r Consulting Full time
Basic Function: This position is responsible for conducting home health assessment, contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities.

ESSENTIAL FUNCTIONS:
  1. Responsible for home health assessments and system updates.
  2. Perform outreach and follow up attempts to members on their health care plan.
  3. Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise.
  4. Inform and educate members on their program, may use supplied scripts. Complete records in system by performing data entry. Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation). Generate appropriate correspondence and send to member manually, electronically, or telephonically.
  5. Conduct check-ins with members to review individual care plan goals.
  6. Maintain production requirements based on established department business needs.
  7. Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate, manage, and close a case within the platform.
  8. Receive, analyze, conduct research and respond to telephone and/or written inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customer or send to appropriate internal party.
  9. Notify help desk of system issues.
  10. Perform data entry function to update customer or provider information.
  11. Obtain required or missing information via correspondence or telephone.
  12. May serve as contact for the various groups regarding claims which involves conducting research, obtaining medical records/letters of medical necessity from TMG, reopen or initiate new cases as needed and refer case to clinicians.
  13. Support and maintain communications with various in-house areas regarding groups? concerns, i.e.: Marketing, Provider Affairs, and SSD.
  14. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
  15. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
  16. Maintain complete confidentiality of company business.
  17. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

Job Requirements:
  • Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience
  • Knowledge of medical terminology
  • Experience coordinating member medical related needs, providing assistance to members, and analyzing member needs
  • PC proficiency including Microsoft Office applications
  • Customer service skill
  • Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues
  • Current state driver license, transportation, and applicable insurance
  • Ability and willingness to travel

Required Qualifications:
LSW, LPN, LPC

  • Member Care Coordinator

    2 weeks ago

    Springfield, United States Integrated Resources Full time

    Job Title: Member Care Coordinator Job Location: Remote + Field Visits in Springfield IL. Job Duration: 6 months with possible extension. Shift: 8:00 AM to 5:00 PM Monday Friday. Job Description Responsible for home health assessments and system updates. Perform outreach and follow up attempts to members on their health care plan. Build...

  • Member Care Coordinator

    2 days ago

    Springfield, United States Integrated Resources, Inc Full time

    Job Title: Member Care Coordinator Job Location: Remote + Field Visits in Springfield IL. Job Duration: 6 months with possible extension. Shift: 8:00 AM to 5:00 PM Monday – Friday. Job Description · Responsible for home health assessments and system updates. · Perform outreach and follow up attempts...

  • Clinical Care Coordinator

    1 month ago

    Springfield, Illinois, United States Springfield Medical Care Systems, Inc. Full time

    :North Star Health, an independent Federally Qualified Health Center comprised of multiple PCMH practices delivering team-based care in Southern VT and Southwestern New Hampshire, is seeking Clinical Care Coordinator at our Springfield Health Center. In this pivotal role, you will engage individuals seeking to prevent and manage chronic conditions, identify...

  • Care Coordinator

    1 week ago

    Springfield, United States Behavioral Health Network Full time

    DescriptionUse your experience working with people with health challenges towards supporting individuals improving their whole health status!Join our team of compassionate and competent professional as a Care Coordinator in the OneCare program at Behavioral Health Network!The Care Coordinator for the One Care Program provides high quality, community-based...

  • Care Coordinator

    2 weeks ago

    Springfield, United States Behavioral Health Network Full time

    DescriptionJoin our team of competent and compassionate professionals as a Care Coordinator in the BHCP program at Behavioral Health Network!Your experience, knowledge and great skills will support the BHCP program with the following: Providing telephonic and in-person Care Management and Care Coordination support to members based on the collaborative spirit...

  • Care Coordinator

    2 weeks ago

    Springfield, United States Behavioral Health Network Full time

    DescriptionJoin our team of competent and compassionate professionals as a Care Coordinator in the BHCP program at Behavioral Health Network!Your experience, knowledge and great skills will support the BHCP program with the following: Providing telephonic and in-person Care Management and Care Coordination support to members based on the collaborative spirit...

  • Care Coordinator

    1 week ago

    Springfield, United States Behavioral Health Network Full time

    Join our team of competent and compassionate professionals as a Care Coordinatorin the BHCP program at Behavioral Health Network! Your experience, knowledge and great skills will support the BHCP program with the following: Providing telephonic and in-person Care Management and Care Coordination support to members based on the collaborative spirit of the...

  • Intensive Care Coordinator

    7 days ago

    Springfield, Illinois, United States Gandara Center Full time

    Intensive Care CoordinatorIn Holyoke, MA, as part of (CBHI) facilitate the process of Intensive Care Coordination services. Complete youth assessments determine need for service. Facilitates Care Planning Team meetings and management/safety plans. Coordinate all team member info and meetings, wh

  • Bcsc Care Coordinator R30580

    4 days ago

    Springfield, United States Baystate Health Full time

    **Category(s)**: Medical Assistant, Care Coordination **Full Time / Part Time**: Full-Time **Shift**: First **Summary**: The Patient Care Coordinator will provide support for delivering quality health care services to a diverse patient population. The position will serve as the portal to the specialty practice and be responsible for appropriate patient...

  • Patient Care Coordinator

    6 days ago

    Springfield, United States PT & Me Full time

    OverviewClinic Name: The Jackson Clinics Position: Patient Care Coordinator Location: Springfield, Virginia Employment Type: Full-TimePay Rate: $18-$20 Dependent on ExperienceThe Jackson Clinics Physical Therapy is a nationally recognized Orthopedic and Sports Medicine Physical Therapy group in Virginia. We are seeking an organized and energetic Patient Care...

  • Patient Care Coordinator

    6 days ago

    Springfield, United States The Jackson Clinics, LP Full time

    Overview Clinic Name: The Jackson Clinics  Position: Patient Care Coordinator  Location: Springfield, Virginia  Employment Type:  Full-Time Pay Rate: $18-$20 Dependent on Experience The Jackson Clinics Physical Therapy is a nationally recognized Orthopedic and Sports Medicine Physical Therapy group in Virginia. We are seeking an organized and...

  • Long Term Care Coordinator I

    7 days ago

    SPRINGFIELD, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Our Illinois Market is currently hiring a Long-Term Care Coordinator I...

  • Long Term Care Coordinator I

    7 days ago

    Springfield, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Our Illinois Market is currently hiring a Long-Term Care Coordinator I...

  • Long Term Care Coordinator I

    6 days ago

    Springfield, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ****NOTE: This role serves community-based members with aging and physical...

  • Long Term Care Coordinator I

    6 days ago

    Springfield, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ****NOTE: This role serves community-based members with aging and physical...

  • Long Term Care Coordinator I

    6 days ago

    Springfield, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Our Illinois Market is currently hiring a Long-Term Care Coordinator I in...

  • Long Term Care Coordinator I

    6 days ago

    Springfield, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.**Our Illinois Market is currently hiring a Long-Term Care Coordinator I in...

  • Long Term Care Coordinator I

    3 days ago

    Springfield, United States Meridian Illinois Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Our Illinois Market is currently hiring a Long-Term Care Coordinator I covering...

  • Long Term Care Coordinator I

    7 days ago

    Springfield, United States Meridian Illinois Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Our Illinois Market is currently hiring a Long-Term Care Coordinator I covering...

  • Service Coordinator

    17 hours ago

    Springfield, United States Advantage Home Care Full time

    Job DescriptionJob DescriptionPay starting $14-$18/hr. We are looking for self-motivated, task oriented candidates able to operate in a busy and fast paced environment. A Team player that has the willingness to learn new concepts and tasks, in a customer service world. Must have computer experience and knowledge.About the JobPay: $14-18 per hourSchedule:8...