Care Coordinator

SUMMARY

This position is responsible for providing ongoing care coordination and support to meet the individual needs of the members. This position is also responsible for promoting continuity of care and cost effectiveness through coordination and integration of functions of case management, utilization review, discharge planning and member outreach. This position is responsible for organizing workflows, managing communications, tracking critical information, creating reports, and establishing links with community resources by performing the following duties.

• Conducts member outreach and evaluation to determine member needs.


• Coordinates with local agencies, primary care providers (PCPs), and community resources to identify and support members in need of care coordination.


• Attends Interdisciplinary Care Team (ICT) meetings, care coordination meetings, and other meetings as assigned.


• Maintains an extensive knowledge base and referral list of local healthcare resources in order to provide care coordination including internal and external referrals to connect members to appropriate community-based resources.


• Manages the care, coordination, and care setting transitions of all assigned members, consulting with Case Managers as needed.


• Develops a working relationship with the member, family or representative, and care team and serves as a member advocate.


• Develops member care plans/shared goals through evaluation of member needs, condition, and situation, in collaboration with the member and consulting with Case Managers as needed.


• Reviews cases with Clinical Operations management or Chief Medical Officer when necessary.


• Provides education, resources, and referrals for both the member and their family or support system.


• Maintains a positive working relationship with providers and community partners.


• Maintains confidentiality and complies with HIPAA rules and regulations.


• Maintains punctual, regular and predictable attendance.


• Works collaboratively in a team environment with a spirit of cooperation.


• Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working with members, providers, and community partners and including the ability to communicate effectively and remain calm and courteous under pressure.


• Respectfully takes direction from manager.

EDUCATION and/or EXPERIENCE

Associate's degree from two-year college or university; and 2 to 4 years related experience and/or training; and/or training; or equivalent combination of education and experience.

COMPUTER SKILLS

Job requires specialized computer skills. Must be adept at using various applications including database, spreadsheet, report writing, project management, graphics, word processing, presentation creation/editing, communicate by e-mail and use scheduling software.

CERTIFICATES, LICENSES, REGISTRATIONS

Traditional Health Care Worker Certification (Community Health Worker or Personal Health Navigator) or the ability to obtain within 18 months of hire.

Hybrid Position