Role Description
The Care Management Care Coordinator functions as an integral part of the Care Management department. They are a member of a team that supports the day-to-day functions of a complex medical network. Activities include, but are not limited to:
• Outreach functions
• Assignment of care management cases
• Mailbox communication and referrals
• Planning, organizing, and prioritizing work to ensure timely completion
• Acting as a key contact and department representative for internal and external customers
Key Responsibilities/Duties
• Support the General Case Management Process within the Case Management Department:
• Initiates outreach cycle and documents in electronic record and/or member referral status.
• Accurately identifies when to escalate issues that may prevent meeting department timelines.
• Track, manage, and triage member needs within the defined intervention period.
• Provide education and coaching to members, families, and/or caregivers.
• Ensure timeliness in coordination of health care services.
• Assist execution of special projects and outreach campaigns.
• Communicate with outside stakeholders and vendors to coordinate member care.
• Perform general office duties:
• Accurately enter data into MedHok, Casetrakker, and/or Jiva.
• Complete clerical and Right Fax tasks as required.
• Effectively prioritize tasks and ensure deadlines are met.
• Employ multi-tasking skills when multiple deliverables are due.
• Accurately identify issues to escalate to a Team Leader.
• Support Clinical Initiatives and Programs:
• Support the development and implementation of programs related to quality measures.
• Participate in outbound calling programs to members with potential quality triggers.
• Provide departmental process support in duties unique to assigned service operations area.
• Attend scheduled meetings and assigned training sessions.
• Other projects and duties as assigned.
Qualifications
• Required (minimum): High School degree.
• Preferred: Associate’s degree in business and/or related administrative or clinical field.
• Required (minimum): 3-5 years’ experience in a professional environment.
• Preferred: Experience in a health care environment, especially in managed care.
• For internal applicants: experience required in Casetrakker, JIVA, or the MedHok platform.
• For external applicants: must demonstrate potential to become proficient in Casetrakker, JIVA, or the MedHok platform within 3 months of training.
Requirements
• Strong knowledge of Clinical Services’ departments and Point32Health organizations.
• Strong computer skills with proficiency in Microsoft Word, Excel, and email programs.
• Experience in Power Point, Access, Visio, and other software applications desirable.
• Work independently and cooperatively as a team member.
• Commitment to excellence in customer service.
• Well-developed written and verbal communication skills.
• Ability to identify emergency situations and follow established protocol.
• Ability to handle multiple demands and balance priorities.
• Strong organizational skills to manage routine workloads and multiple tasks.
• Ability to increase workload and be flexible with coverage responsibilities.
• Must exercise sound judgment and communicate effectively in a telephonic office and remote environment.
Working Conditions and Additional Requirements
• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard.
• May be required to work additional hours beyond the standard work schedule.
• Fast-paced office environment handling multiple demands independently.
• Ability to enter data and type information during telephone conversations.
• Ability to carry 5 – 25 pounds of materials over a distance of approximately 100 yards.
• Digital and manual dexterity required for keyboard use and display monitor work.
Benefits
• Medical, dental, and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health