Care Coordination Specialist

2 weeks ago

Bakersfield, California, United States Universal Healthcare MSO LLC Full time
Position Overview

Role Summary:

The Healthcare Case Management Associate plays a crucial role in supporting the Case Management Department, particularly assisting Nurse Case Managers and the Social Services team through effective service coordination within the Enhanced Care Management (ECM) Program.

This position is responsible for managing low acuity cases, facilitating enhanced care coordination activities, monitoring patient progress, documenting findings, and collecting clinical data from external sources.

The ECM Program is designed to address both clinical and non-clinical needs of individuals facing complex medical and social challenges through systematic service coordination and comprehensive care management.

Targeted towards individuals with chronic health issues, those experiencing homelessness or at risk, and patients with frequent hospital admissions, substance use, or behavioral health concerns, this role demands strong interpersonal and organizational skills to foster relationships with members, coordinate referrals, and liaise with various healthcare providers and community services.

The Healthcare Case Management Associate collaborates with the member's interdisciplinary team (ICT) to support the individual while engaging them and their support systems to identify priorities central to their needs and goals.

Employment Type: Full-Time

Work Environment: Onsite

Work Schedule: Monday-Friday 8am-5pm

Compensation:

The anticipated salary range for this role is between $18.00 and $24.00 per hour. However, the final compensation may vary based on individual qualifications, including relevant experience and skills. We are committed to offering competitive compensation packages to attract and retain exceptional talent.

Key Responsibilities:

  • Effectively manage low acuity member cases within the ECM Program.
  • Engage with members regularly according to their acuity level and care plan requirements.
  • Conduct member assessments and consistently document care management activities in the CM System, adhering to program protocols.
  • Collaborate with clinical and social services Case Managers to facilitate care coordination, member follow-up, and communication with relevant agencies.
  • Assist in managing members requiring Transitional Care Services (TCS).
  • Gather clinical information and coordinate post-discharge services, including scheduling appointments and ensuring members understand follow-up care needs.
  • Initiate care transition coordination with referral sources and internal partners to ensure smooth transitions to home or other care settings.
  • Report any variances or issues to the assigned nursing or social services staff.
  • Assist members with appointment scheduling, transportation, referral coordination, and other care coordination services.
  • Verify member eligibility, demographic details, and benefits.
  • Maintain data integrity by entering information into departmental systems.
  • Provide general office administration, including answering phones and delivering customer service to members and partnering agencies.
  • Gather relevant information during assessments, care planning, and interdisciplinary meetings.
  • Outreach to members to ensure their needs are met and services are delivered.
  • Act as a resource for members, providers, and staff regarding policies and care coordination.
  • Participate in Interdisciplinary Care Team (ICT) meetings to communicate member needs and preferences.
  • Attend mandatory departmental meetings and assist in training new staff.
  • Perform additional duties as assigned.

Qualifications:

  • High School diploma or GED required.
  • A minimum of 3 years of experience in a healthcare or community health setting.
  • Familiarity with prior authorization or case management regulations governing various health programs.
  • Experience in a managed healthcare environment is preferred.
  • Medical Assistant or Community Health Worker certification is a plus.

Skills and Competencies:

  • Ability to provide excellent customer service and respect the needs of members and team members.
  • Willingness to collaborate with professionals at all levels to achieve goals.
  • Sensitivity to social, cultural, and financial differences among members.
  • Strong problem-solving skills and ability to prioritize tasks based on member needs.
  • Excellent verbal and written communication skills.
  • Proficiency in using electronic Case Management systems and common office technology.
  • Ability to maintain confidentiality and professionalism in a dynamic environment.

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