Care Coordinator
Job Summary
Care Coordinators provide essential management services to help members navigate the healthcare system. They support interdisciplinary teams by handling member inquiries and coordinating care needs effectively. The role focuses on identifying risk factors, documenting interactions, and ensuring services are delivered to improve health outcomes.
Responsibilities
- Manage incoming member inquiries and benefit questions
- Perform risk screenings and document in PHI systems
- Coordinate care for assigned member caseloads
- Collaborate with interdisciplinary teams
- Conduct service outreach and verification calls
Required Skills
- CMA, CNA, or RMA certification
- Medical terminology familiarity
- Strong verbal and written communication
- Multi-tasking in fast-paced environments
- Proficiency in customer service and organization
Job Details
Duties and Responsibilities:
- Receive incoming calls from members regarding benefit questions/issues, care coordination, program inquiries, connecting to their care manager, and screening assessments to identify risk factors requiring medical intervention.
- Contemporaneously and accurately documents calls in designated PHI system.
- Manages an assigned member caseload who require short term care coordination and health navigation.
- Works within the interdisciplinary care team to support timely communication of member issues or needs and monitors screening of members effectively to improve quality and cost outcomes.
- Performs outreach calls to members to confirm services are in place.
Minimum Qualifications:
- Certified Medical Assistant (CMA) or Certified Nursing Assistant (CNA) or Registered Medical Assistant (RMA) or previous relevant medical training or work experience.
- HS diploma/GED.
- Work experience requiring effective communication verbally and in writing while demonstrating good grammar, spelling, and punctuation skills.
- Experience working in a fast-paced environment that requires handling multiple priorities simultaneously.
Preferred Qualifications:
- Associate's Degree.
- Prior work experience in a call center, care management, or healthcare environment or familiarity with medical terminology, Medicaid & Child health plus benefit products.
- Excellent telephone, organizational, and customer service skills.
- Team player who is organized and detail-oriented.