Care Management Coordinator

Care Management Coordinator

The Care Management Coordinator is expected to ensure high quality, cost-effective care and services for Elderplan/HomeFirst members through support of professional Care Management activities. The position supports all aspects of care coordination for our Medicaid, and/or dual product members in compliance with all departmental and CMS/DOH regulatory requirements. The position requires excellent communication and organizational skills to facilitate superior care management and to act as a liaison between the members, the care management team, and the vendors.

Processes all newly enrolled cases according to established EP/HF Coordinated Care team workflows and maintains integrity of members' files

Receives and processes requests and inquiries through interdepartmental communication system regarding covered/ non covered services/supplies

Receives and processes initial requests and inquiries regarding pre-authorization of services/supplies.

Coordinates and provides service authorizations to vendors

Accurate and timely data entry support as defined by departmental workflows

Participates in scheduled team meetings

Qualifications include:

• High School Diploma or equivalent; college degree preferred.
• One year prior managed care experience required.
• Prior experience in a health care setting preferred.
• Familiarity with utilization management/case management.

Min USD $40,000.00/Yr. Max USD $44,000.00/Yr.