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 memberâs 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 processCare 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 populationProvide transition of care interventions as requiredFacilitate care coordination, self-management planning, discharge planning, and health education as directedFacilitate linkage to appropriate community resources to address social determinants of healthCapacity to adjudicate referrals according to defined business rules across all care settingAdheres 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 DiplomaMinimum 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 skillsStrong work ethic and overall positive attitudeEffective communication skills including verbal and writtenAbility to manage time effectively, understand directions, and work independently in a fast-paced environmentDemonstrated flexibility, organization, and self-motivationHighly 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.
