Clinical Care Coordinator II

2 weeks ago


Denver, Colorado, United States Elevance Health Full time

Position Overview: The Clinical Care Coordinator II plays a pivotal role in managing the healthcare journey of members with intricate and chronic health conditions. This position requires a dedicated professional who is adept at assessing, developing, implementing, coordinating, monitoring, and evaluating comprehensive care plans aimed at enhancing member health outcomes throughout the care continuum.

Key Responsibilities:

  • Facilitate member access to essential services tailored to their health requirements through proactive care coordination.
  • Identify unique member needs and devise specific care management strategies to meet established objectives and goals during assessments.
  • Execute care plans by coordinating authorizations and referrals as necessary within the benefits framework or through alternative arrangements.
  • Continuously monitor and assess the effectiveness of care management strategies, making adjustments as needed.
  • Collaborate with Medical Directors and Physician Advisors to formulate care management treatment plans.
  • Assist in resolving issues related to providers, claims, or service delivery.
  • Contribute to the development of utilization and care management policies and procedures.

Qualifications:

  • Bachelor's degree in a health-related discipline and a minimum of five years of clinical experience.
  • Bilingual proficiency in English and Spanish is preferred.
  • Experience in post-discharge planning and transitional care is highly desirable.
  • Knowledge of chronic health conditions such as CHD and Type II Diabetes is advantageous.
  • Familiarity with Member 360, HIP, and the ability to navigate multiple digital platforms simultaneously is essential.
  • Experience in telephonic nursing is a plus.

Compensation and Benefits: Elevance Health offers a competitive salary range and a comprehensive benefits package that includes health insurance, retirement plans, and various incentive programs, all subject to eligibility criteria.

Company Commitment: Elevance Health is dedicated to fostering an inclusive workplace that promotes equal pay opportunities for all employees, irrespective of gender, race, or other protected categories.

Work Environment: Elevance Health embraces a hybrid workforce strategy, requiring associates to work at an Elevance Health location at least once a week unless specified otherwise.

Health and Safety: The health and safety of our associates and communities are paramount. Compliance with vaccination requirements for certain roles is mandatory.

Equal Opportunity Employer: Elevance Health is an Equal Employment Opportunity employer, ensuring that all qualified applicants receive consideration for employment without discrimination based on any protected status.



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