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