Care Coordinator - Oklahoma City

ROLE AND RESPONSIBILITIES
The Care Coordinator (CC) assists with the care coordination of member care of both Utilization and Disease Management/Wellness. Under the direction and supervision of the Care Manager-RN, the Care Coordinator assists members by providing support, education and assistance in the prevention and/or maintenance of their disease and/or health and wellness state; by assisting in supporting member compliance with treatment plans; and by assisting in the collaborative coordination of care to reduce waste and inefficiency.

CORE FUNCTIONS

  • Care Coordinator reports to the management staff and is under the direct supervision of the Care Manager-RN.

  • Provides telephonic follow up with members for Care Management services to include post hospital discharge and chronic condition management.

  • Complete assigned tasks related to care coordination.

  • Generate tasks to the assigned Care Manager-RN.

As directed and supervised by the Care Manager-RN assist in the attainment of members’ goals by:

  • Working with member, physician, other care providers to meet the member’s individual needs based on protocols and referrals

  • Calling the identified member to offer a review of the Disease Management program

  • Supporting the member education goals regarding their specific chronic condition based on the Plan of Care

  • Informing the member how to access resources

  • Assisting in the arrangement of Provider follow-up appointments and delivery of care

  • Mailing of approved educational and informational material

  • Assisting in the performance of calls to members post discharge from inpatient or other levels of care

  • Supporting the monitoring and evaluation of interventions in the Plan of Care

  • All communications will be conducted in a professional manner.

  • Remains objective in their review and not participate in any way in the delivery of care to the patient.

  • Administers tasks as detailed in the member specific Plan of Care.

  • Completes clear and concise documentation in Care Management programs.

  • Participates in weekly Complex Case Review.

  • Assists with handling incoming and outgoing calls: answering questions regarding the referrals and obtaining information as requested by licensed staff.

  • Assists with data entry, faxing, filing and other clerical tasks.

  • Complies with Customer Service expectations as applicable to the Department and Health Plan.

  • Comply with all departmental policies and procedures.

  • Participate in departmental and company in-services as appropriate.

  • Recognizes and adheres to the scope / limitations of job requirements.

  • Comply with all departmental policies and procedures.

  • Participate in departmental and company in-services as appropriate.

  • Performs other related duties as assigned.

QUALIFICATIONS AND EDUCATION REQUIREMENTS

  • High school graduate. Some college education preferred in the allied health professional field of study.

  • Behavioral health and/or healthcare-related experience is preferred.

  • Strong organizational and time management skills, able to work with little supervision while handling numerous projects at once.

  • Excellent written/verbal communication skills, especially the ability to communicate telephonically in a professional and effective manner.

  • Computer literacy in Word and Excel.


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