BusinessOperations - Care Coordinator II - J01000

Overview

Position

Purpose:

Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.

Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate.

Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed.

Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan.

Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service.

May support performing service assessments/screenings for members and documenting the member’s care needs.

Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed.

Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards.

Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager.

Provide education on benefits and resources available.

Performs other duties as assigned.

Complies with all policies and standards.

Requires a High School diploma or GED. Requires 1 – 2 years of related experience.

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”

• Health plan or business unit
• Team culture
• Surrounding team & key projects
• Purpose of this team
• Reason for the request
• Motivators for this need
• Any additional upcoming hiring needs?

• Health Plan: Superior Health Plan
• Team Name: STAR PLUS Waiver DME Team
• Purpose of Team :
  Coordination of durable medical equipment, medical supplies and adaptive aides for the STAR PLUS waiver population.
• Reason for Request :
  Backfill for special project

• Daily schedule & OT expectations
• Typical task breakdown and rhythm
• Interaction level with team
• Work environment description

• Schedule : M-F 8a-5p CT. Overtime will be required based on business needs.
• Work Environment :
  Remote.
• Daily responsibilities of role :
  Focus on coordinating durable medical equipment (DME), medical supplies, and adaptive aids for the STAR PLUS Waiver population. Coordination of service requests will consist of educating members regarding DME benefits and DME requirements. Helping members schedule primary care physician (PCP) appointments. Identifying a DME agency that can provide items needed. Coordinate with DME agencies, PCPs and members to ensure DME orders are obtained, and all requirements are met for an authorization.
  
  Advocate for members to ensure members receive needed DME item. Follow-up with member to confirm delivery and satisfaction with DME item.

• What makes this role interesting?
• Points about team culture
• Competitive market comparison
• Unique selling points
• Value added or experience gained

• The primary focus of our team is to ensure members receive the DME/Medical Supplies they need to have a good quality of life in their community. We meet this goal through advocacy and education.