Care Coordinator (Must reside in Oregon)

Sun Life•Bend, OR

3d•Onsite

About The Position

The Care Coordinator is responsible for telephone outreach to designated member populations to ensure retention, utilization of services, and satisfaction as well as meeting compliance regulations with reporting on these topics. Must reside in Oregon.

Requirements

High school diploma or equivalent
6+ months of experience working with Medicaid populations by phone or in person, or equivalent
Computer proficiency in a variety of Windows applications
Attends additional training as requested/deemed necessary
Must reside in Oregon.

Nice To Haves

Certification as a Community Health Worker or other Traditional Health Worker designation
2+ years of experience working in a call center environment.
Experience in a dental/medical insurance setting.

Responsibilities

Assist with care coordination of members with special health care needs as designated by Coordinated Care Organizations (CCOs), the Oregon Health Authority (OHA), members, members’ caregiver or their representative.
Contacting and counseling members in regards to emergency department usage for dental related reasons as reported through company’s secure connect to the Emergency Department Information Exchange (EDIE) or directly from hospitals and CCOs.
Contacting and counseling members in regards to missing dental appointments as reported by primary care dental offices (PCDs).
Assisting in the reassignment of dismissed of members from their current PCD and coordinating success care in the future for the member; escalating to a Care Coordinator, Advanced when necessary.
Coordinating care for members needing additional services in a dental practice after being seen in a community setting.
Community Partner Requests for assistance through Health Risk Screening.
Processing medical to dental referrals to care.
Processing of Pilot projects referrals to care.
Ensure all documentation is entered accurately and timely into all case management systems for continuity of care purposes.
Assist in improving the region’s health by considering each community member’s unique health, cultural and social needs.
Other duties as needed or required.