Care Coordinator-1

Point32Health • Canton, MA

4h • Hybrid

About The Position

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-today functions of a complex medical network and activities include, but not limited to, outreach functions, assignment of care management cases, mailbox communication and referrals, other. This individual must be able to plan, organize, and prioritize work to ensure completion in a timely manner. He/she functions as a key contact and department representative both to internal and external customers of the care management department through verbal and written communications.

Requirements

• High School degree.
• 3-5 years’ experience in a professional environment.
• Strong knowledge of Clinical Services’ departments and Point32Health organizations in order to assess situations and direct internal and external customers appropriately accurately and quickly.
• Strong computer skills with proficiency required in Microsoft Word, Excel, in an e-mail program and the Intranet.
• Work independently and cooperatively as a team member across multiple levels within the organization
• Must have a commitment to excellence in customer service.
• Must have well developed written and verbal communication skills.
• Ability to identify emergency situations and follow the established protocol.
• Ability to handle multiple demands and must be able to balance multiple priorities within set protocols and procedures.
• Strong organizational skills to be able to handle a routine workload and multiple tasks while maintaining excellent customer service.
• Ability to increase workload and be flexible with coverage responsibilities to meet strict department deadlines.
• Must be able to exercise sound judgement as necessary and to work and communicate with customers in a telephonic office and remote environment.
• 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 and sitting for extended durations.
• May be required to work additional hours beyond the standard work schedule.
• Fast paced office environment handling multiple demands independently.
• A cubicle-based hoteling and remote work environment, which presents challenges to maintaining focus on the work while exposed to other voices and work sounds.
• Ability to enter data and type the information received during a telephone conversation.
• Ability to carry 5 – 25 pounds of materials from one business area to another, approximately a distance of 100 yards.
• Digital and manual dexterity required for keyboard along with ability to work on a display monitor for long periods of time.

Nice To Haves

• Associate’s degree in business and/or related administrative or clinical field is highly desirable.
• Experience in a health care environment, especially in managed care is highly desirable
• For internal applicants, experience is required in) Casetrakker, JIVA or the MedHok platform.
• External applicants must demonstrate potential to become proficient in Casetrakker, JIVA or the MedHok platform within 3 months of training.
• Experience in Power Point, Access, Visio, and other software applications desirable.

Responsibilities

• Support the General Case Management Process within Case Management Department: Initiates outreach cycle and documents in electronic record and/or member referral status.
• Accurately identifies when to escalate issues which may prevent meeting department timelines for completion of notification to providers for denials and for requests for information.
• Track, manage and triage member needs within the defined intervention period for the member specific population, complete follow-up responsibilities within required timeframe.
• Provide education and coaching to the member, family, and/or caregiver about follow up care and health status, goals of transition care, and health insurance benefits to assist members in making the most informed decisions and to promote self-management of care!
• Ensure timeliness in coordination of health care services.
• Assist members with scheduling appointments, tests, screenings, and transportation.
• Assist execution of special projects and outreach campaigns
• Communicate with outside stakeholders and vendors appropriately to coordinate member care as needed.
• Performs general office duties: Accurately enter data into MedHok, Casetrakker and/or Jiva, and other databases and tracking programs
• 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 identifies any issues to escalate to a Team Leader
• Support Clinical Initiatives and Programs: Supports the development and implementation of programs related to quality measures.
• Participate in outbound calling programs to members with potential quality triggers.
• Provides departmental process support in duties unique to assigned service operations area.
• Attends scheduled meetings and assigned training sessions.
• Other projects and duties as assigned.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED