Enhanced Care Management Coordinator (ECM)

Statement of Purpose

Under the direct supervision of the Quality Improvement Director, the ECM Care Coordinator will provide care coordination and care management services for specified populations of focus in the ECM program using standard formats that have been developed by DHCS. The Care Manager will advocate on behalf of enrolled members with primary care providers, specialty services, hospitals, and community-based support systems to meet identified needs of members prioritizing patient's health and well-being.

Essential Functions, Knowledge, Skills And Abilities

• The ECM Care Coordinator reviews data and conducts necessary assessments with all potentially eligible members to verify eligibility in the ECM program upon consent, as well as completing the referral process if applicable.
• Responsible for coordinating with individuals and/or external entities to ensure an impeccable experience for the member while developing a person-centered relationship with the patient and/or identified family supports.
• Oversee provision of ECM services, including completion of assessment, development of Managed Care Plan (MCP) guidelines and connect member to external social support services and supports required by patient, including and not limited to transportation services.
• Maintaining knowledge of available community support services and recourses available to members
• Work alongside healthcare professionals, health plans, community and social support services, and other company employees
• Manage, review, reassess and update members care plan as necessary, while documenting evidence of care in member's chart using the EHR system in a concise and timely manner
• Scheduling appointments, completing check in and check out process at time of appointment with assigned member while documenting every encounter pertaining to the patient to meet established reporting requirements
• Maintain a number of required documented outreach attempts and monthly in person or telephonic visits - number of visits vary as determined by the acuity and complexity of the enrollee.
• Collaborate with appropriate discharge planners upon hospital admission and/or ER visits of enrolled members. Outreach at ER or hospitals if applicable
• Notify necessary clinical consultant or PCP of any complex behavioral, medical psycho-social, or behavioral issues. As well as other applicable staff to reduce barriers and improve patient outcomes
• If necessary, accompany members to office visits to serve as an advocate
• Identifies and follows up on referrals to assure continuity of care assuring patient needs are being met
• Addresses members' questions, concerns and requests in a timely manner as well as investigates a directs member inquiries or complaints to appropriate staff while following up to ensure satisfactory resolution
• Follows policies to enroll and discharge enrolled members as necessary
• Recognizing signs of child and elder abuse and reports appropriately to Child/Adult Protective Services
• Participate in care coordination meetings if applicable.
• Understands and abides by all departmental and companywide policies and procedures while complying with all safety and injury prevention policies and regulations
• Knowledge of and ability to work collaboratively with providers, social support services, and other external entities related to the care of the patient
• Demonstrates excellent communication skills, and ability to work as a team member
• Works independently to accomplish established outcomes
• Maintains professional etiquette and strictest confidentiality
• Maintains a positive and respectful attitude while delivering excellent "customer service".
• Self-motivates to perform department tasks as needed.
  
  

Required Education And Experience

• Minimum Education: High school graduate of GED equivalent required.
• Current BLS lifesaving support certificate is required.
• Current and valid Driver's License and proof of auto insurance is required.
  
  

Preferred Education And Experience

• Bilingual in English and Spanish is preferred
• Two-year medical assistant experience in an office or clinic setting is preferred.
  
  

Other Duties

• Maintains a positive and respectful attitude while delivering excellent "customer service".
• Have excellent verbal, written and presentation skills.
• Strong attention to detail.
• Strong analytical skills.
• Communicates with fellow employees, management and supervised employees (if any) on a regular basis.
• Self-motivates to perform department tasks as needed.
• Maintains the strictest confidentiality.
• Performs in a professional manner and puts forth their best effort.
• Communicates openly and consistently with Supervisor(s) and all staff.
• Performs related work as required.
• Demonstrates ability to work harmoniously with others to get a job done.
• Attitude promotes positive work environment.
• Respects others co-workers, business partners and patients.
• Resolves issues and conflicts at the onset by going to the source whenever possible.
• Communicates effectively with team members and provides constructive suggestions to improve team performance.
  
  

Work Environment

Office environment with controlled temperature

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m. Occasional evening and weekend work may be required as job duties demand.

Travel

Occasional travel necessary when completing patient outreach to patient with location specified by patient. Another example of travel would be driving to ALTURA's various clinic locations.

Altura Centers for Health retains the right to change or modify job duties at any time. The above job description is not all encompassing. Needs and requirements may vary according to business needs or necessity. Altura Centers for Health is an employer "at-will" and nothing in this document is intended to, nor does, alter the existing "at-will" employment relationship.

Job Type: Full-time

Pay: $25.50 - $40.90 per hour

Benefits

• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
  
  

Work Location: In person