Outpatient Care Coordinator

Job Description

Job Description

POSITION SUMMARY

Under the supervision of Case Management leadership, the Outpatient Care Coordinator supports day-to-day care management operations by coordinating non-clinical activities, facilitating communication with members, providers, facilities, and the clinical team, and helping ensure timely follow-up after hospital or facility discharge. The Care Coordinator supports continuity of care, member engagement, appropriate use of healthcare resources, and accurate documentation in accordance with AMM policies, procedures, health plan requirements, and applicable regulatory standards. This position works closely with Case Managers and other members of the Care Management team to help achieve quality, utilization, and member outcome goals.

RESPONSIBILITIES-DUTIES

Support members enrolled in Care Management programs and coordinate services in accordance with AMM policies, procedures, and established workflows.

• Monitor and track member discharges from inpatient hospitals, skilled nursing facilities, and other applicable care settings to support timely post-discharge follow-up.

• Assist with the Care Management intake and enrollment process, including outreach, collection of required information, and routing of clinical needs to the appropriate Case Manager.

• Complete timely post-discharge outreach to members or authorized representatives using approved scripts and workflows, and document outreach attempts and outcomes in the designated system.

• During post-discharge outreach, collect information regarding medication reconciliation needs, follow-up appointments, durable medical equipment, home health, transportation, referrals, and other care coordination needs, and escalate clinical concerns to the Case Manager or licensed clinical staff.

• Collaborate with inpatient and outpatient Case Managers to support transitions of care and identify opportunities to reduce avoidable ER visits and hospital readmissions, including readmissions within 30 days.

• Serve as a non-clinical point of contact for members, families, providers, and facilities and route clinical questions or urgent concerns to licensed clinical staff as appropriate.

• Assist with obtaining medical records, discharge summaries, medication lists, and other documentation needed to support care coordination and continuity of care.

• Upload, scan, index, and maintain records in the appropriate system or shared location in accordance with department procedures and privacy requirements.

• Communicate identified member needs and barriers to the assigned Case Manager and other appropriate members of the Care Management team.

• Coordinate with primary care providers, specialists, facilities, and ancillary providers regarding referrals, follow-up appointments, records, and other non-clinical care coordination needs.

• Document all member, provider, and facility outreach accurately, completely, and timely in the designated care management system.

• Follow Care Management program guidelines, approved communication standards, HIPAA/privacy requirements, and member rights requirements when communicating with members and providers.

• Identify and promptly escalate potential safety concerns, changes in condition, inability to reach a high-risk member, or other issues requiring clinical review to the appropriate licensed staff or leadership.

• Maintain assigned work queues, task lists, reports, and follow-up activities to ensure required actions are completed within established timeframes.

• Participate in team meetings, training, quality improvement activities, audits, and department initiatives.

• Identify workflow improvement opportunities and make recommendations to improve departmental efficiency, member experience, and continuity of care.

• Maintain flexibility and adaptability in response to operational needs and changing priorities.

• Support organizational goals and comply with workplace safety standards.

• Perform special projects and other duties as assigned within the scope of the Care Coordinator role.

EDUCATION AND EXPERIENCE REQUIREMENTS

• High school diploma or equivalent required; associate degree or additional education in healthcare, medical assisting, health administration, or a related field preferred.

• •Previous experience in healthcare, managed care, care management, utilization management, medical office, hospital, or health plan operations preferred.

• Experience communicating with patients/members, providers, hospitals, and healthcare teams in a professional and service-oriented manner.

• Proficiency with Microsoft Office applications and the ability to learn electronic health record, care management, authorization, and other healthcare software systems.

• Knowledge of medical terminology and basic healthcare processes preferred.

• Strong organizational, time-management, follow-up, communication, and documentation skills.

• Ability to manage multiple priorities, maintain confidentiality, and work effectively in a fast-paced team environment.

• Demonstrated compassion, professionalism, and respect when interacting with members and their families.

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!