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.
- 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 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.
- 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.
- 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.