Care Management Coordinator II

L.A. Care Health Plan•Los Angeles, CA

4d•Remote

About The Position

The Care Management Coordinator II is responsible for outreach to members/caregivers, providers, Community Based Organizations (CBO), and others to help enroll the highest need members into the Care Management (CM) and Disease Management (DM) programs. This role involves assessing member strengths, challenges, needs, and barriers to care through telephonic Health Risk Assessments (HRA). The position collaborates with the member/caregiver, Care Management Specialist, Community Health Worker, and the Interdisciplinary Care Team (ICT) to support the development and implementation of the care plan and address unmet needs. The Care Management Coordinator II facilitates communication between the CM team and various stakeholders, including members/caregivers, providers, and medical groups. They support member care coordination as directed by the Care Management Specialist, reinforcing health education, coordinating benefits like transportation and DME, and connecting members to community resources to address Social Determinants of Health (SDoH). This role ensures the CM team meets contractual and regulatory requirements through accurate documentation and follow-up. Additionally, the position undertakes projects to support departmental needs, such as running reports, data validation, and quality checks, while maintaining member information confidentiality.

Requirements

High School Diploma/or High School Equivalency Certificate
At least 6 months of experience in an administrative and customer service role in a health care/health services setting.
Knowledge of medical terminology
Strong verbal and written communication skills
Proficiency in Microsoft Office with a high level of accuracy
Excellent organizational, and time management skills
Detail-oriented and a team player
Excellent customer service skills with compassion and empathy
Ability to demonstrate sensitivity and respect for the opinions, perspectives, customs, and individual differences of others.
Ability to value diversity of people and ideas, as well as interact with people from a wide range of backgrounds.
Ability to be flexible, open-minded, listen to and consider others’ viewpoints.
Ability to work well and develop effective relationships with diverse personalities.

Nice To Haves

Associate's Degree
1 year of Medical Assistant experience.
6 months of experience processing authorizations at a managed care/health plan setting.
Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.
Certified Medical Assistant (CMA)
Motivation Interviewing
Trauma Informed Care

Responsibilities

Responsible for time-sensitive processes for initiating cases, managing referrals, appropriate documentation, routing of information, computer data input, faxing, emailing, filing of confidential member information, and maintaining logs of activity.
Engages members to participate in the CM/Disease Management programs by promoting the programs to address member’s unmet needs.
Completes telephonic calls to conduct the HRA with high-risk members participating in the CM program and assists the care team with developing and assessing health interventions.
Conducts telephonic outreach calls to members/caregivers regularly and evaluates and documents their progress towards their healthcare goals. Consults and collaborates with the Care Management Specialist to set up provider/specialist appointments and follow up on treatment plans.
Handles incoming and outgoing calls to members/caregivers and providers to coordinate care as identified in the care plan.
Initiates follow-up calls to members to administer screenings or confirm linkage to appropriate resources and provides general information to members and providers about the CM and DM programs.
Performs other duties as assigned.