Care Coordinator
2 days ago
Molina Healthcare is hiring for a Care Coordinator. This role is remote with a preference for location being in/near southeastern Wisconsin.
The (non-clinical) Care Coordinator works with members, providers, and multidisciplinary team members, focusing on specific HEDIS measures- Asthma, Diabetes, and Hypertension. This role will assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.
Qualifications- A passion for providing the education needed to members to help manage and improve chronic health conditions.
- Background or experience in social work, community health, Community Health Worker (CHW), public health, health education, Certified Health Education Specialist (CHES), or the like.
- Above average computers skills (able to work proficiently in MS Outlook, Word, Excel).
- Performs care coordination activities in collaboration with healthcare providers, other HCS staff, involved medical case managers, case management processors, community-based organizations (CBOs), and other providers as required to provide timely and accurate service authorizations and integrated care.
- Assist members with social determinant of health needs, challenges in accessing health & community resources, or other needs that fragment care and lead to poor health outcomes.
- Documents all findings, contacts, and interventions in the electronic care management system.
- Collaborates with state agencies, healthcare professionals, and community support systems to promote integrated care.
- Expected to meet daily production standards in terms of member outreach.
- Provide face-to-face care coordination activities in the communities where members reside.
- Assesses for barriers to care, provides care coordination and assistance to members to address psychosocial, financial, and medical obstacle concerns.
- Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements and converts these terms to configuration parameters.
- Coordinating the authorization of needed services such as timely approval of durable medical equipment, pharmacy, and medical supplies.
- Ensuring access to medically necessary physical health or behavioral health through assisting with appointments and transportation services.
- Provides coaching/information for available health services or health education.
- Required Education: Bachelor’s Degree in a healthcare related field; however, relevant experience will be considered in lieu of degree.
- Required Experience: Para-professional whose background is anchored in social work or community health systems – per contract can be non-licensed. Min. 1 year clinical experience.
- Preferred Qualifications: Experience in social services, medical terminology, and managed care environment; including knowledge of applicable state and federal regulations and standards.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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