Healthcare Coordinator
4 weeks ago
The Care Management Specialist at Marys Healthcare System for Children plays a vital role in achieving the six core care management functions of the designated health home. This position is responsible for coordinating services to meet the goals of the child's comprehensive patient/family focused plan of care, with high/medium/low acuity levels. The specialist builds relationships with the parent/caregiver and child's care team (physicians, nurses, social workers, etc.) to ensure the provision of services. They assist parents/caregivers with navigating systems, access issues, and service coordination, empowering them to participate in all aspects of care. As a liaison to outside agencies, the specialist acts as a conduit for the transmission of information between St Mary's care management and the assigned health home. This role supports St Mary's mission to provide the highest quality of care management services by complying with regulatory guidelines and meeting agency standards.
JOB DUTIES / RESPONSIBILITIES:
1. The specialist completes the Child and Adolescent Needs Assessment (CANS) to identify the child's medical, social, educational, and psychological needs. They develop a plan of care that is comprehensive of all the child's identified needs.
2. The specialist initiates and builds relationships with the parent/caregiver/family, designated health home, and managed care service providers to coordinate services.
3. They complete all required and necessary visits/contacts to ensure that the child is receiving coordinated services.
4. The specialist works with Managed Medicaid provider and internal supports to ensure Medicaid eligibility and medical provider network enrollment.
5. They participate in team meetings with Health Homes Care Coordination Supervisor to review and implement the plan of care.
6. The specialist provides communication to the management team on any updates and identified problems and discusses enhanced work processes.
7. They initiate and attend team patient care conferences for complex and/or multi-disciplinary patients, whenever needed.
8. The specialist meets all Pediatric Health Homes data entry and documentation requirements.
9. They ensure monthly productivity statistics are in accordance with Health Homes and St Mary's care management requirements.
10. The specialist participates in all required Health Homes and St Mary's care management trainings and ongoing assessment tool education.
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