Care Coordinator - SCO

Care Coordinator - SCO

We have a care coordinator transferring to a new position outside of SCO and require an assistant for our other care coordinator while backfilling the position.

Qualifications:

• Education: Associate's degree in Healthcare, Nursing, and Social Work or a related area or equivalent relevant work experience desired.
• Experience: 2 years of office experience, specifically in either a high volume data entry office, customer service call center, or health care office administration department.
• Preferred/Desirable: Experience with FACETS or other healthcare database. Experience with Health Plan Utilization / Claims departments. Prior customer service experience. Bilingual skills, fluency in Spanish. Experience in working with the geriatric/elder population.
• Competencies, Skills, and Attributes: Strong Motivational Interviewing skills. Strong oral and written communication skills. Bilingual preferred. Ability to effectively collaborate with health care providers and all members of the PCT. 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. Attention to detail. Strong computer skills. Strong phone skills. Highly organized.

Responsibilities:

• Perform telephonic outreach to durable medical equipment (DME) vendors to order DME for our SCO Enrollees.
• Assist with implementing community resources.
• Reach out to Providers for Enrollee care plan submission and prescription requests.
• Establish Enrollee cases within the care management documentation system, generate letters, and coordinate with the SCO care manager for Enrollee services.
• Maintain current knowledge of the Aging Services Access Points (ASAPS) and community-based resources for referral and linkage to Enrollee's needs.
• Maintain the SCO department electronic mailbox for faxes, prescriptions, care plans and outside vendor requests.
• Be a part of the SCO Primary Care Team (PCT) that is led by the Care Manager for SCO and includes the Primary Care Physician and other Providers, the ASAPS, the Geriatric Supports Services Coordinator (GSSC), Beacon Behavioral Health Strategies staff, other non-clinicians, pharmacists, and others.
• Provide support of the PCT, as requested by the Care Manager.
• Document in the care management documentation system.
• May perform face to face visits/meetings with the PCT and/or the Enrollee, or with community agencies, per the request of the Care Manager for SCO.
• Assess Enrollee needs and coordinate with the SCO care managers.
• Track down Enrollee phone numbers and addresses.
• Send information packets to Enrollees containing health information relative to the Enrollee's identified conditions and needs.
• Maintain current knowledge of ASAP and community resources for referral and linkage to Enrollee's needs.
• Participate in group meetings to ensure policies, procedures, and work flows are up to date and advise on revisions needed.
• Participate in PCT meetings, as requested.
• Facilitate Enrollee needs by collaborating with the care manager and partners with providers such as Mass Health, clinical vendors, ASAPS, GSSC's, and primary care and specialty practices.
• Complete documentation in the medical management information system [CCMS] in a timely manner and in keeping with contractual requirements, internal policy and accreditation standards.
• Comply with established metrics for performance, adhere to documentation and work flow standards and utilize other department specific tracking tools.
• Triage cases to the SCO clinical care management staff, other departments, contracted vendors and providers, as appropriate.
• Participate as assigned in answering calls on the care management 800 line.
• Maintain HIPAA standards and confidentiality of protected health information.
• Report critical incidents and information regarding quality of care issues.
• Serve and participate in pertinent committees and meetings as needed.
• Assist with new staff training.
• Regular and reliable attendance is an essential function of this position.