Care Coordinator

4 days ago

Newark, Delaware, United States Global Force Full time
Care Coordinator Job Description

At Global Force, we are seeking a highly skilled Care Coordinator to join our team. As a Care Coordinator, you will play a critical role in supporting the development of and executing on the outreach strategy in a certain territory for the purposes of influencing health outcomes and member engagement.

Key Responsibilities:
  • Assist providers in discharge planning for Level 1 members following acute episodes of care involving inpatient psychiatric stays, ambulatory surgeries, hospital inpatient stays, and rehabilitation facility services.
  • Provide appointment setting, referrals, and linkages to services, coordination of DME, and coordination of prior authorizations to support timely access to services in the community.
  • Closing social determinants of health and care gaps through appointment assistance, coordinating transportation, connection to community resources, and wellness programs.
  • Establish connections and act as the primary ACFC contact to a targeted member population through home visits, community visits, and outreach calls.
  • Exercise judgment and discretion in the coordination of care by handling basic care follow-up tasks and collaborating with AmeriHealth Caritas care coordination teams, community-based healthcare providers, and other organizations.
  • Inform members of required actions to fulfill HEDIS, EPSDT, and Plan requirements and other referred outreach through phone calls or home visits, and encourage compliance.
  • Assist in addressing members' barriers to care and to encourage/foster relationships with their medical/dental providers (medical/dental homes).
Requirements:
  • Community-based care experience preferred.
  • Behavioral health experience preferred.
  • Previous experience in presenting health education materials to individuals and small groups.
  • Knowledge and understanding of medical terminology and disease processes.
  • Ability to effectively communicate preventive health and health management philosophies to members and agencies.
  • Comprehensive knowledge of Medicaid requirements and plan, policies, and procedures.
  • Knowledge of managed care.
  • Valid driver's license and willingness to drive a car.
Education:

Associate's Degree in Healthcare, Human Services, or a related field or equivalent work experience. Bachelor's Degree preferred.

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