Care Coordinator (Remote NC)

Vaya Health

3d•Remote

About The Position

The Care Coordinator is responsible for providing proactive intervention and telephonic coordination of care to eligible members to ensure that they receive appropriate screening, assessment, services, and care transitions. Responsibilities include administering screenings and assessments, developing care plans to achieve a member’s health goals, and managing discharges/transitions between care settings. Care coordinators possess customer service and active listening skills needed to guide individuals of varying backgrounds towards their goals for whole person health. Care Coordinators perform telephonic outreach and engagement activities for members who are eligible for Tailored Care Management and also provide care coordination for members who qualify for supportive Social Determinants of Health services. Note: This position requires access to, and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her capacity as an employee of Vaya Health. The individual filling this position shall also sign a confidentiality statement as an employee of Vaya Health.

Requirements

A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance.
Exceptional interpersonal skills, effective oral and written communication skills, and the ability to make prompt independent decisions based upon relevant facts
Problem solving, negotiation, and conflict resolution skills are essential to balance the needs of both internal and external customers.
The employee must be detail oriented, able to organize multiple tasks and priorities, and to effectively manage projects from start to finish. Work activities quickly change according to mandated changes and changing priorities. The employee must be able to shift focus to meet changing priorities.
Knowledge of Behavioral Health/I/DD Tailored Plan (Tailored Plan) eligibility and services
Working understanding of the concepts of whole-person health and health-related resource needs (formerly known as social determinants of health)
Community integration (Independent living skills; transition and diversion, supportive housing, employment, etc.)
Health promotion (Common physical comorbidities, self-management, use of IT, care planning, ongoing coordination)
Person-centered needs assessment and care planning, etc.
Serving pregnant and postpartum women with SUD or with SUD history
Thorough knowledge of standard office practices, procedures, equipment, and techniques and have intermediate to advanced proficiency in Microsoft Office products (Word, Excel, Power Point, Outlook, Teams, etc.)
Bachelor’s Degree in Human Services and at least two (2) years of progressive experience providing similar services to the population served.
OR
Bachelor’s Degree in a field other than Human Services and at least four (4) years of progressive experience providing similar services to the population served.
To meet federal requirements for Care Coordination, the incumbent must be qualified as a Qualified Professional according to 10A NCAC 27G .0104.
Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
Mental concentration is required in all aspects of work.
The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border.

Nice To Haves

Call Center (inbound/outbound) experience
Tailored Care Management experience
Care Coordination experience
SDoH experience
Medical Administration or Assessment
Customer Success
At least four (4) years of post-degree experience in customer success management, communications, and/or administrative care)

Responsibilities

Telephonic outreach and engagement for members eligible for plan-based Tailored Care Management (TCM).
Referring members who opt in to TCM for assignment to a care manager.
Provide telephonic outreach and administration of Care Needs Screenings to all Vaya Medicaid plan members.
Provide telephonic outreach and engagement to members eligible for care coordination.
Conducting the above activities according to applicable rules, regulations, and contract requirements as outlined in Vaya policy and procedure
Documenting above activities in designated software platforms according to Vaya policy and procedure
Provide telephonic assessment and person-centered care planning for members who opt in to Care Coordination.
Link members to appropriate care to meet their care plan goals, coordinate member care including locating appropriate providers and services, assisting with appointment reminders, and providing education about relevant health topics and recommended screenings and immunizations
Manage transitions of care between settings ensuring that members receive appropriate discharge planning and follow up with discharge appointments
Assessing eligibility for the NC Healthy Opportunities Pilot and linking eligible members to these services using the NCCARE360 software platform
Conducting above activities in the designated software platform according to Vaya policy and procedure.
Other duties as assigned.