Care Coordinator- Care Management

Qualifications: Qualifications: Education Required: • Associate's degree in Healthcare, Nursing, and Social Work or a related area or equivalent relevant work experience. Experience Required: • 2 years of office experience, specifically in either a high volume data entry office, customer service calls center, or health care office administration department. Preferred/Desirable: • Knowledge and experience in maternal child health. • Experience with FACETS/CCMS or other healthcare database. • Experience with care coordination or case/care management • Prior customer service experience. • Bilingual skills, fluency in Spanish. Certification or Conditions of Employment: • Pre-employment background check Competencies, Skills, and Attributes: • Motivational Interviewing skills • Strong oral and written communication skills • Ability to effectively collaborate with health care providers and all members of the interdisciplinary team • Demonstrated strong organizational and time management skills • Able to work in a fast paced environment and multi task • Experience with Microsoft Office application, particularly MS Outlook and MS Word and other data entry processing applications • Knowledge of medical terminology strongly preferred • Knowledge of community resources strongly preferred Working Conditions and Physical Effort: • Work is normally performed in a typical interior/office work environment. • No or very limited physical effort required. No or very limited exposure to physical risk. • Regular and reliable attendance is an essential function of the position Responsibilities: Key Functions/Responsibilities: • Assesses member needs by conducting interviews and structured assessments using Motivational Interviewing techniques to engage Members and determine non-clinical and social needs and engage them in care management. • Educates members by providing information on how to obtain resources, basic health information and by sending information packets to Members containing health information relative to the Member's identified conditions. • Maintains current knowledge of community resources for referral and linkage to meet Members' needs • Participates in group meetings to ensure policies, procedures, and work flows are up to date and advises on revisions needed. • Facilitates member communication with external partners such as state agencies, community based organizations, clinical vendors, and primary care and specialty practices. • Completes documentation in the medical management information system [CCMS] in a timely manner and in keeping with contractual requirements, internal policy and accreditation standards. • Complies with established metrics for performance, adheres to documentation and work flow standards and utilizes other department specific tracking tools. • Triages cases to clinical staff, other departments, contracted vendors and providers as appropriate. • Participates as assigned in answering calls on the care management 800 line Program Specific Functions • Transition to Home (TTH) o Runs TTH census report admissions with TTH with Match Report and removes program ineligible members. o Creates cases in CCMS and checks for discharge dates in CCMS by referencing the facility census or by contacting the facility. o Telephonically outreaches to select full program members o Calls short program members to ensure an appointment with the PCP or specialist has been set up within a week of discharge and assists member in making appointments as needed. • Sunny Start o Supports members to access necessary equipment such as breast pumps and infant car seats within members benefit structure o Facilitates member access to and completion of prenatal and postpartum visits according to best practice guidelines and workflow standards. Supervision Exercised: • n/a Supervision Received: • Weekly and on-going from Manager of Care Management