Member Care Coordinator

Job Description

Job Title: Member Care Coordinator | LVN | LPN

Location: Albuquerque NM / Hybrid

Duration: 12+ months contract to hire

Pay rate: $31.00/hr or $62k conversion salary

BASIC FUNCTION:

This position is responsible for conducting home health assessment, contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities.

ESSENTIAL FUNCTIONS:

1. Responsible for home health assessments and system updates.

2. Perform outreach and follow up attempts to members on their health care plan.

3. Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise.

4. Inform and educate members on their program, may use supplied scripts. Complete records in system by performing data entry. Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation). Generate appropriate correspondence and send to member manually, electronically, or telephonically.

5. Conduct check-ins with members to review individual care plan goals.

JOB REQUIREMENTS:

 Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.

 Knowledge of medical terminology

 Experience coordinating member medical related needs, providing assistance to members, and analyzing member needs

 PC proficiency including Microsoft Office applications

 Customer service skills

 Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues

 Current state driver license, transportation, and applicable insurance

 Ability and willingness to travel