Care Coordinator (Hybrid, Weekends)

UHS • Reno, NV

4d • Hybrid

About The Position

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Under general supervision, the Care Coordinator is a frontline, member-facing Health Services staff member who performs a wide variety of duties to engage, support, advocate, and educate members in overall health and wellness, as well as Prominence Health benefits, community resources, and other health information. The Care Coordinator serves as a liaison, or link, between Prominence and the member. The Care Coordinator works, under the supervision of the clinical staff, to increase members’ health knowledge and self-sufficiency through a range of activities such as post-discharge follow up, post emergency department follow-up, case management engagement, coordination of services, including appointment scheduling, arranging home health and DME services, health education, informal counseling, social support, and advocacy.
The Care Coordinator adheres to unlicensed professional scope of practice and scope outlined by the position. Additionally, the position participates in efforts associated with the successful operation of the SNP CM program and that the model of care (MOC) meets or exceeds regulatory and accreditation requirements for the Centers for Medicare and Medicaid Services (CMS), state Medicaid offices (as relevant), and NCQA.

Requirements

• Minimum 2 years’ experience in health care / medical field customer service or similar public contact work related to communication, problem-solving, and customer satisfaction is required.
• Valid Driver’s license, applicable insurance, reliable home internet if working remote, and reliable transportation required.
• Excellent computer skills.
• Able to work with a diverse multicultural and socioeconomic population.
• Familiarity with health care delivery and/or health insurance programs.
• Knowledge of medical terminology.
• Ability to prioritize and multi-task.
• Strong problem-solving and critical thinking skills.
• Ability to travel local and regional up to 20 to 30% of the time.

Nice To Haves

• Bachelor’s degree in Community Health, Public Health, preferred
• Certification in Medical Assistant, Nursing Assistant, or relatable field, preferred.
• Experience working with the Medicare and Medicaid population segment preferred.
• Knowledge of Medicare/ Medicaid processes and compliance standards.

Responsibilities

• Engage, support, advocate, and educate members in overall health and wellness, as well as Prominence Health benefits, community resources, and other health information.
• Serve as a liaison between Prominence and the member.
• Increase members’ health knowledge and self-sufficiency through activities such as post-discharge follow up, post emergency department follow-up, case management engagement, coordination of services, including appointment scheduling, arranging home health and DME services, health education, informal counseling, social support, and advocacy.
• Adhere to unlicensed professional scope of practice and scope outlined by the position.
• Participate in efforts associated with the successful operation of the SNP CM program.
• Ensure the model of care (MOC) meets or exceeds regulatory and accreditation requirements for the Centers for Medicare and Medicaid Services (CMS), state Medicaid offices (as relevant), and NCQA.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level