Case Management Coordinator

DOCTORS HEALTHCARE PLANS, INC.•Coral Gables, FL

About The Position

The Case Management Coordinator plays an important and unique role in the Care Coordination and Case Management team. This role involves assisting patients in navigating managed care systems, improving care coordination, reducing barriers to healthcare, and empowering patients to become self-advocates. The coordinator will also provide support after ED and hospital discharges, link patients with community resources, and conduct outreach activities.

Requirements

Minimum 2 years in a healthcare administrative role, preferred.
Excellent computer skills - data entry, outlook, excel.
Strong attention to detail.
Excellent verbal and written communication skills.

Responsibilities

Have a thorough understanding of the many benefits and coverage offered by the different managed care products, including all DHCP plans.
Improve coordination of patient care, reduce and remove cultural and healthcare system barriers.
Promote timely treatment.
Empower and coach patients to become self-advocates.
Assist patients navigate the maze of the managed care delivery system.
Assist Case Management Manager with MBR’s TOC outreach calls.
Be the system navigator and point of contact for patients enrolled in managed care programs, assist patients with benefit coverage and access to care questions/concerns.
Provide enhanced care coordination services assisting patients in problem solving with issues related to the health care system, financial or social barriers (e.g. transportation as appropriate, prescription drugs formulary assistance, etc.).
Track and support patients when they obtain services such as. Emergency Departments, Hospitals, and other health care offices and facilities.
Provide immediate care coordination services after ED and hospital discharges.
Identify and link patients with cultural and community resources to facilitate referrals and respond to social services needs.
Collaborate with other services providers for care coordination and case management activities.
Work with patients over the phone to review and remind their plan of care and progress towards their care management goals.
Conduct outreach activities to assigned members by phone, mail or any other form of communication method to promote program engagement and marketing strategy assist in data collection and report statistical information.
Perform other job duties as required by manager/supervisor.