Description

POSITION SUMMARY

The Care Coordinator provides non-clinical case management support functions for care management services of members enrolled through ILS’ client health plans to assist in promoting effective education, self-management support, and timely healthcare delivery to achieve optimal quality and positive outcomes. The Care Coordinator behaves in a professional manner, and consistently demonstrates and promotes the values of respect, honesty, care and dignity for the members as well as all other team members involved in the servicing of ILS’ clients. The Care Coordinator is involved in care management support services inclusive of Special Needs Members (SNP), Seniors and Persons with Disabilities (SPD), private insurance, Medicare, and state’s Medicaid programs. The Care Coordinator works to support the care management model including coordination, management and follow-up on non-direct clinical interventions. The Care Coordinator is responsible to assist Clinical Care Managers and Non-Clinical Care Managers in the coordination and implementation of various interventions in members’ individualized care plans.

REQUREMENTS FOR ALL POSITIONS

All employees shall meet Compliance/Privacy Regulations and attend at a minimum one (1) hour of Compliance/Privacy educational training annually, as required by Independent Living Systems.

All employees if duly licensed in the State of employment, and said license is part of the requirement of their position with Independent Living Systems, shall maintain in good standing and current state licensure.

All employees are required to maintain confidentiality, protect privacy, comply with PHI regulations, and report violations.

POSITION RESPONSIBILITES AND ACCOUTABILITY

• Assists Clinical Care Manager and Non-Clinical Care Manager to coordinate interventions for individualized care plans.
• Contacts members as necessary to assist in coordination of services.
• Prioritizes members according to intensity, need, and required follow-up.
• Provides feedback and information to Clinical Care Managers and Non-Clinical Care Managers as needed.
• Identifies and effectively utilizes health plan benefits and community resources to meet the needs of members and caregivers.
• Makes appropriate referrals to other programs to address the member’s needs
• Assists in report production, data collection and data entry for care plan management.
• Collaborates with interdisciplinary care team and facilitates case reviews as necessary.
• Coordinates provision of social services, home & community-based services and other identified services and resources.
• Provides member education during care management activities
• Completes Health Risk Assessment (HRA) as appropriate per contracts.
• Maintains accurate and timely documentation in the electronic care management system.
• Participates in orientation of new personnel
• Participates in regular team meetings and department in-services
• Works in conjunction with others on the team and promotes collaborative teamwork
• Adheres to organizational policies and procedures
• Maintains a working knowledge of and adheres to applicable federal/state regulations including but not limited to, laws related to patient confidentiality, release of information, and HIPAA.
• Maintains appropriate professional boundaries.
• Uses safe work practices. Promptly reports workplace and patient safety issues to supervisor.
• Interacts in a manner, which is professional, respectful, positive, helpful, and promotes trust.
• Maintains professional growth and development
• Complies with all requirements of the Care Management Model of Care
• Other duties as assigned.

POSITION QULIFICATION

Minimum Education:

• Associates degree in health care related field preferred.
• Prior experience in a health care setting
• Understanding of Medical Terminology Minimum Experience:

• 1 years in healthcare
• Basic knowledge of care management processes
• Other: Basic computer skills including data entry (database), MS Word.
  • Strong communication skills including verbal and writing skills
  • Valid Drivers License

Qualifications