Care Coordinator

ROLE AND RESPONSIBILITIES

Under the direction and supervision of the Care Manager, 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.

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 services related to post hospital discharge chronic condition management, educational health information with appointment requests.

  • Complete assigned tasks related to care coordination.

  • Generate tasks and queues to the assigned Care Manager.

  • As directed and supervised by the Care Manager 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

    • providing approved educational and informational materials

    • 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

    • utilizes call prioritization tools for call queueing

  • Administers tasks as detailed in the member specific plan of care approved by the Care Manager.

  • Completes clear and concise documentation in Care Management programs.

  • Participates in the quality care conference program.

  • 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.

  • Performs other related duties as assigned.

  • Active participant in care integration platform.

QUALIFICATIONS AND EDUCATION REQUIREMENTS

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

  • 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, Excel.

  • Ability to handle multiple demands of diverse workload and prioritize urgent issues.

  • Accountable with strong work ethic


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