Care Coordinator, BH

WellSense Health Plan

3h•$20 - $29•Remote

About The Position

The Care Coordinator, BH is a member of the Behavioral Health Care Management (BH CM) team whose role is to perform telephonic outreach and screenings of identified members and to provide coordination of BH and community resources. The Care Coordinator, BH supports members and providers across service areas, identifies facilities and programs, and advocates and coordinates care for the members to ensure access to BH services and to community resources that address social determinants of health. The Care Coordinator, BH triages for and collaborates with clinical staff to ensure members receive appropriate care management. The Care Coordinator, BH collaborates with their clinical team members, the Customer Care department and other internal departments to support member needs.

Requirements

Associate’s degree required in health care or a related area.
Experience in either a high-volume customer service call center, data entry office, or health care office administration department.
Strong motivational interviewing skills
Ability to engage members
Strong oral and written communication skills
Detail oriented
Ability to work independently but also in a team setting
Ability to effectively collaborate with health care providers and all members of the interdisciplinary team
Demonstrated strong organizational and time management skills
Demonstrated ability to successfully prioritize, plan, organize and manage multiple tasks in a face-paced environment
Intermediate skill level with Microsoft Office products – Outlook, Word, Excel
Regular and reliable attendance is an essential function of the position

Nice To Haves

Bachelor’s degree in psychology, social work, or related area
Prior customer service/call center experience
Prior work with Medicaid population preferred
Bilingual
Knowledge of medical terminology strongly preferred

Responsibilities

Uses motivational interviewing skills to engage members into care management via telephonic outreach.
Provides information to members with the goal of increasing member knowledge and participation in their own healthcare management including but not limited to information on how to obtain resources; basic health information; information packets containing health information relative to the Member’s identified condition.
Maintains current knowledge of community resources for referral and linkage to meet Members’ needs.
Advocates for the Member and coordinates BH/SUD and community resources.
Answers and triages calls from the department’s toll-free line.
Monitors the team’s mailbox and relays information received to Care Managers and triages referrals received via email.
Triages cases to clinical staff.
Facilitates referrals, performs telephonic screenings, arranges wellness visits and provides appointment and preventative care reminders, as needed.
Coordinates and facilitates access to BH/SUD services, resolves issues related to social determinants of health and collaborates with providers, facilities, state agencies, BH CM team, and other departments.
Maintains accurate and timely documentation in the medical management information system (Jiva) in keeping with contractual requirements, internal policy and accreditation standards.
Partners with department leadership and team members to organize staff assignments, prioritize and triage activities and calls.
Provide administrative support to the BH CM team.
Responsible for preparing department data/reports assigned by Management.
Identifies opportunities for improvement in administrative workflows and processes.
Performs other associated tasks as assigned by Manager/Supervisor.