About The Position

The Care Coordinator provides specialty service care coordination to members in foster care and pediatric members identified as being adopted. The role ensures appropriate services are delivered by specialty providers and continuity of care across services, and is responsible for the beneficiary’s total care plan, encompassing all services and plans. Case management must comply with Conflict Free Case Management rules. The position involves outreach and family engagement, coordinating healthcare and community-based supports, developing and supporting the Person-Centered Support Plan (PCSP), and addressing barriers to care. The role also contributes to health education, quality improvement, patient panel management, and service performance goals.

Requirements

  • High school diploma or equivalent.
  • Ability to determine the approach, resources, and goals needed to meet business objectives and member needs.
  • Ability to analyze and translate medical and clinical diagnoses and procedures into designated numerical codes.
  • Ability to handle multiple priorities at once.
  • Excellent written and verbal communication skills.
  • Valid driver's license and automobile insurance.

Nice To Haves

  • Bachelor’s degree in social science or a health-related field.
  • At least 1 year of experience caring for developmentally or intellectually disabled clients or behavioral health clients.
  • At least 6 months of care coordination experience with pediatric members in foster care or identified as being adopted.

Responsibilities

  • Provide high-touch outreach to assigned members and intensive engagement with relevant guardians and caregivers.
  • Coordinate wraparound services, support, and advocacy for families during adoption or a child welfare journey.
  • Help members meet healthcare needs by ensuring providers and services work together to improve health.
  • Provide health education and coaching tailored to issues identified in treatment and service plans.
  • Develop the Person-Centered Support Plan (PCSP) and offer members choices in the process.
  • Ensure compliance with the PCSP and help address resource needs and barriers to treatment.
  • Coordinate with healthcare providers for diagnostics, ambulatory care, and hospital services.
  • Assist members with social determinants of health, including access to exercise and healthy food.
  • Promote patient and community health activities, including outreach, quality improvement, and patient panel management.
  • Coordinate community-based management of medication therapy.
  • Participate in staff meetings and clinical conferences.
  • Ensure performance guarantees are met or exceeded.
  • Interface with internal and external customers to support efficient service.
  • Perform other duties and responsibilities as assigned.
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