Personal Care Coordinator

At Sunshine Enterprise USA, we're not just a company; we're a community of dedicated professionals committed to excellence and innovation. As a leading force in the business landscape, we take pride in bringing together great people and great organizations by fostering a work environment that values creativity, diversity, and growth. If you're ready to embark on a rewarding career journey with a company that prioritizes its employees, explore our current job opportunities below.

Position Responsibilities

• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  
• Performs outreach to members to coordinate completion of the initial and annual HRA, conducts telephonic and/or in-person HRAs as necessary and ensures data entry of HRAs received via email.
  
• Interviews members to determine strengths, problems, functional status, goals and need for specific services/resources.
  
• Maintains documentation of member’s case, care plan, interventions, and interdisciplinary care team within the medical management system.
  
• Collaborates with PCP and health care team to ensure timely communication of member’s clinical information.
  
• Partners with licensed professionals in the development of an initial care plan for each member, incorporating the HRA and all assessment findings.
  
• Facilitates communication of initial care plan to the PCP and member, as necessary.
  
• Identifies the need for, and facilitates, referrals to Long Term Support Services (LTSS), Behavioral Health and community resources.
  
• Oversees warm transfers to member’s assigned Case Manager in accordance with member needs, when appropriate.
  
• Works with Case Management staff to expedite the resolution of member concerns.
  
• Guides members in understanding and accessing the benefits they are entitled to under Medi-Cal.
  
• Notifies member’s care team of key event triggers.
  
• Maintains compliance with established departmental productivity guidelines.
  
• Ensures reporting of productivity metrics to supervisor as required.
  
• Completes other projects and duties as assigned.
  

Possesses the Ability To:

• Maintain accurate records and documentation.
  
• Contribute to the development of a plan based on assessment of the member’s physical, psychosocial, functional, strengths/barriers and mental health needs.
  
• Establish and maintain effective working relationships with the leadership and staff.
  
• Communicate clearly and concisely, both orally and in writing with individuals from a diverse population.
  
• Utilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
  

Experience & Education

• High School diploma or equivalent required.
  
• 1 year of experience working with the needs of seniors or persons with disabilities (SPD) in a customer/member service capacity required.
  
• Bilingual in English and one of the defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese) required.
  
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
  
• A valid driver’s license and vehicle, or other approved means of transportation, an acceptable driving record, and current auto insurance will be required for work away from the primary office 20% of the time or more.
  

Preferred Qualifications

• Bachelor’s degree in healthcare management or related field.
  
• 1 year of Health Maintenance Organization (HMO), Medi-Cal and/or health services experience.
  

Knowledge of:

• Principles and practices of health care service delivery and managed care, eligibility and benefits, and Medi-Cal.
  
• Long-term services and support.
  
• Issues that face members with special needs, such as seniors and persons with disabilities.
  
• Principles and techniques to serve the SPD population in diverse social and ethnic groups.
  

Sunshine Enterprise USA is an “Equal Opportunity Employer—Minorities, Females, Veterans and Disabled Persons”