Care Coordinator

Overview

Coordinates member care, conducts assessments, and supports health outcomes.

Key Responsibilities

• care planning
• risk assessment
• case evaluation
• quality review
• member coaching
• data documentation

Tasks

-Coordinates and implements assigned care plan activities and monitors care plan progress. -Completes Health Risk assessments-both initial and annual for selected members -Evaluation of members using care management tools, information and data to conduct comprehensive evaluations of member’s needs/eligibility and recommends an approach to case resolution and/or meeting member’s needs by evaluating their benefit plan and available internal and external resources. -Enhancement of medical appropriateness and quality of care using a holistic approach including but not limited to consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review to achieve optimal outcomes. -Identifies high risk factors and service needs that may impact the member outcomes and determine the care planning components with appropriate referrals to clinical case management or crisis intervention as appropriate. -Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. -Identifies and escalates quality of care issues through established channels. -Encourage and assist members to actively participate with their provider in healthcare decision making -Monitor, evaluate, and document care by utilizing case and quality management processes in compliance with regulatory and accreditation requirements and company policies and procedures.

Requirements

• ms office
• lpn
• case management
• managed care
• behavioral health
• problem solving

What You Bring

-Proficiency with standard corporate software applications, including Outlook, MS Word, Excel, as well as some proprietary applications -Ability to work independently -Effective communications, organizational, and interpersonal skills -3 years working in managed care setting preferred -Case Management and discharge planning experienced preferred -Analytical and problem-solving skills -Effective computer skills including navigating multiple systems -2-3 years of experience in behavioral health, social service or appreciate related field equivalent to program focus -Confidence working as independent thinker, using tools to collaborate and connect with teams virtually -Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. -LPN with active, unrestricted licensure preferred

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Benefits

-A competitive salary based on the market -Employer-Paid Life Insurance -401(K) match up to 4% -Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc. -Medical, Dental, and Vision

About tecsa

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