Healthcare Services Coordinator

5 days ago

Orange, California, United States Alta Hospitals Full time
Job Description

The Outpatient Care Coordinator II is a key member of our interdisciplinary care team, responsible for identifying and reducing barriers to members' care. They will assist members in locating and accessing resources, educate them on the importance of accessing care promptly, and serve as the primary point of contact. This role is integral to the members' care team and requires efficient management and prioritization of assigned caseloads.

Responsibilities:
  • Conduct telephonic outreach to members to discuss and offer outpatient clinical programs.
  • Oversee a caseload of basic members to manage and coordinate care according to members' identified needs.
  • Interact with assigned members telephonically and/or in-person as appropriate.
  • Review of Health Risk Assessment and identification of members' coordination of care needs.
  • Establish member-friendly care goals with members.
  • Coordinate care for members as appropriate, including scheduling appointments, creating authorizations, and facilitating requests.
  • Facilitate completion of quality measures through education and coordination.
  • Timely processing of incoming referrals to outpatient programs.
  • Completes post-discharge calls for members and determines additional post-discharge needs.
  • Collaborates with the health plan, PCP, and healthcare team to ensure timely coordination of members' needs.
  • Facilitates warm transfers to members' assigned case managers in accordance with members' needs.
  • Identifies the need for and facilitates referrals to Long Term Support Services (LTSS), Behavioral Health, and other community resources.
  • Guides members in understanding and accessing health plan benefits.
  • Maintains timely documentation of members' cases, care plans, interventions, and interdisciplinary care team within our care management system.
  • Mails educational and community resources information to members.
  • Assists case managers in obtaining medical records for members.
  • Generates letters, faxes them to PCPs, and mails them to members along with resources.
  • Maintains compliance with established departmental productivity guidelines.
  • Maintains internal department trackers and reports.

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