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Care Coordination Specialist
2 months ago
Position Overview
The Care Coordination Specialist plays a pivotal role in managing the healthcare journey of individual clients, particularly within designated populations. This position involves a comprehensive approach to assessment, care planning, implementation, coordination, monitoring, and evaluation to achieve cost-effective and high-quality outcomes.
Key Responsibilities
- Coordinate care for members with identified behavioral health conditions, ensuring they receive the necessary intensive interventions and oversight.
- Conduct thorough health risk assessments and comprehensive needs evaluations, addressing psycho-social, physical, medical, behavioral, environmental, and financial factors.
- Develop and communicate care plans, serving as the primary contact to ensure appropriate service delivery during transitions to home care and community-based services.
- Implement and monitor strategies aimed at enhancing health and quality of life outcomes for members and their families.
- Document and execute plans that provide essential resources to meet social, physical, mental, emotional, spiritual, and supportive needs.
- Advocate for members' care requirements by identifying and addressing gaps in service delivery.
- Continuously monitor and evaluate the effectiveness of care plans, making adjustments as necessary.
- Analyze clinical path variance data to identify potential areas for service improvement.
- Collaborate with the interdisciplinary care team, which may include members, caregivers, legal representatives, physicians, and support services, to address care issues and specific member needs.
- Educate providers, support staff, members, and families about the care coordination role and health strategies, emphasizing a member-centered approach.
- Facilitate a collaborative team approach to ensure the effective and economical delivery of quality care and services.
- Maintain professional relationships with external stakeholders, including inpatient, outpatient, and community resources.
Qualifications
- 3-5 years of experience in Social Work, Nursing, or a related healthcare field, or equivalent experience in lieu of a degree.
- Experience in utilization management, quality assurance, community health, or long-term care is essential.
- Strong analytical skills to interpret data and identify trends.
- Effective verbal and written communication skills, with the ability to collaborate with clinicians and service agency contacts.
This position offers a competitive salary and a comprehensive benefits package, including health, life, and voluntary benefits designed to enhance overall well-being.
