Overview

SCOPE OF ROLE

The role of the Care Coordinator is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, and advocating to ensure member’s receive services and resources required to meet desired health and social outcomes. The Care Coordinator is responsible for providing patient centered care across the care continuum.

ROLE RESPONSIBILITIES

  • Capacity to collect relevant clinical data to support the care planning process
  • Care Plan support and intervention to transition members to optimal levels of health and self-management, as directed.
  • Collaboration across providers and healthcare settings to ensure optimal quality outcomes for an assigned population
  • Provide transition of care interventions as required
  • Facilitate care coordination, self-management planning, discharge planning, and health education as directed
  • Facilitate linkage to appropriate community resources to address social determinants of health
  • Capacity to adjudicate referrals according to defined business rules across all care setting
  • Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • High School Diploma
  • Minimum 2 years of experience in medical management.
  • Capacity to interpret health plan benefit decisions  

LICENSURES AND CERTIFICATIONS

  • Certification as a Medical Assistant preferred

PROFESSIONAL COMPETENCIES

  • High level of critical thinking and problem-solving skills
  • Strong work ethic and overall positive attitude
  • Effective communication skills including verbal and written
  • Ability to manage time effectively, understand directions, and work independently in a fast-paced environment
  • Demonstrated flexibility, organization, and self-motivation
  • Highly adaptable to change

WORK ENVIRONMENT

  • The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
  • Some travel may be required.