Transition Coordinator (Albany Region)

Summary The Transition Coordinator will work in support of the Hospital to Home program by coordinating efforts of medical and behavioral health care managers to ensure that all members who are hospitalized leave with comprehensive discharge plans. The Care Coordinator may engage members and/or their loved one's face to face in one of our Hospital to Home facilities and may collaborate with hospital treatment teams and discharge planners. Engagement may also occur over the phone and through electronic channels such as email, Microsoft Teams and fax. Outreach may include but is not limited to: appointment setting, member communication about gaps in care and preventive health opportunities, member and provider education, communication campaigns, prior authorization process for step down treatments, home care, durable medical equipment and medications. The Care Coordinator will assist with mail processing, materials organization, technology/service requests and other administrative tasks as necessary. This position is based in one or more Hospital to Home facilities and therefore requires hospital clearance and compliance with any hospital standards (ie. physical exam, PPD, up to date with vaccinations). Responsibilities Work collaboratively with other members of the CDPHP Care Management team, including Registered Nurses and Social Workers; as well as collaborators from other areas of Member Health, Member Services and State Programs. Exhibit strong customer intimacy and ability to prioritize needs for complex hospital discharges, with support from clinical staff when needed; Engage effectively through written and verbal communication with both members and providers; Conduct targeted member and provider outreach via face to face engagement, phone calls and mail communication; Work collaboratively with members and families to build rapport and positively impact overall health status and compliance with health care service; Schedule member appointments and ensure timely sharing of hospital records with primary and specialty care providers, ensuring proper consents are in place; Schedule meetings and/or conferences by interacting with internal partners and/or external clients/partners to coordinate calendars, accommodations, meeting materials and supplies; Serves as a resource pertaining to the authorization process for member/provider inquiries (requires a familiarity with plan benefit design and CDPHP prior authorization process); Respond to ad-hoc requests (filing, copying, responding to problems with printers, etc.), Coordinate and monitor project status and/or manage small projects/programs, and/or participate in larger projects representing the team; Practice and adhere to departmental, organizational and state guidelines; Contribute to several projects simultaneously and effectively. Develop and implement new solutions that enhance the efficiencies within the department; Participate in data collection through accurate documentation and record keeping; Adapt to changing work priorities and a fast-paced environment while maintaining a professional attitude; Maintain comprehensive computerized records of all case management activities; Maintain effective, cooperative working relationships with people both internally and externally as it relates to the operations and business of CDPHP; Facilitates communication links among different disciplines involved in the member's treatment; Work independently and maintain confidentiality at all times; Work additional hours as needed; The employee agrees to comply with CDPHP's Corporate Compliance Policy and all laws, rules, regulations and standards of conduct relating to the Corporate Compliance Policy and has a duty and obligation to report any suspected violations of any law, the standards of conduct or Corporate Compliance Policy to his or her immediate Supervisor, the fraud and abuse hotline, the Compliance Officer, the Compliance Director, Human Capital Management or the Chief Executive Officer; Performs other duties as assigned. Minimum Qualifications Associates degree or two (2) years of equivalent experience required. Associates degree in human services or related field preferred. Minimum one (1) year of experience working in customer service required. Experience with Government or State Programs population preferred. Experience with and knowledge of social determinants of health required. Proficiency in Microsoft Outlook, Word, and Excel required. Knowledge or experience in PowerPoint, Access or other database software preferred. Strong understanding of community characteristics and resources in the local community preferred. Bilingual preferred. Excellent verbal and written communication skills. Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions. Demonstrated ability to work with and maintain confidential information. Demonstrated ability to provide excellent customer service and develop relationships both internally and externally. Flexibility to adapt to a changing and fast-paced environment. Ability to travel locally as needed. Access to reliable transportation and a valid driver's license is required. Compensation Range(s) N4: Minimum: $19.22 - Maximum: $30.76 All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. #J-18808-Ljbffr Capital District Physicians Health Plan Inc