Clinical Care Coordinator (44758)

Neighborhood Health Plan of Rhode Island•Smithfield, RI

10d•Onsite

About The Position

The Clinical Care Coordinator is responsible for welcoming and onboarding new members to the health plan, completing and scheduling assessments and works collaboratively with the health care team to manage and coordinate care for members. This role is also responsible for locating and reengaging those who are difficult/unable to reach through office and community-based efforts. Community-based efforts include, but are not limited to: member home visits, provider office visits, hospitals and other areas. The Clinical Care Coordinator must work collaboratively with members, caregivers, member relatives and health care providers to ensure quality and cost-effective patient-centered care. The Clinical Care Coordinator should feel comfortable when working to overcome environmental, cultural and language barriers. This position works directly with members, staff, managers, and both internal/external customers.

Requirements

Associates Degree in human service related field or equivalent years of background and relevant work experience to equal the degree
Minimum of one (1) or more years working in community outreach or within a community-based organization setting with individuals having social, behavioral and/or long-term care needs
Three (3)+ years’ experience in medical or social services setting or minimum of six (6) months experience working in a position within Neighborhood Health Plan of Rhode Island
Knowledge of community social service resources, State agencies and the state Medicaid program
Ability to conduct telephonic, virtual and in-person assessments with clear communication
Strong oral and written communication skills
Strong customer service orientation
Strong interpersonal skills
Strong organizational skills
Ability to problem solve and work independently with minimal supervision
Strong collaborative skills and teamwork values
Computer literacy with windows-based programs
Sound judgment and strong time management skills
Ability to keep accurate records and documentation using electronic medical record/care management system
Flexible schedule including evenings and weekends
Ability to travel for work, must have access to reliable transportation and/or valid driver’s license and proof of insurance if using personal vehicle

Nice To Haves

Clinical specialty experience
Knowledge of medical terminology
Knowledge/expertise in substance use and/or mental health
Bilingual

Responsibilities

Under the direction of the Manager within Clinical Operations, the Clinical Care Coordinator performs ongoing care coordination activities including:
Conducts outreach telephonically, virtually, and/or face to face
Completes Health Risk Assessment (HRA), initial health screening and member welcome calls
Provides telephonic initial screen of non-medical needs, coordinates services with clinical team and makes appropriate referrals
Provides information to members/clients and/or their care teams regarding social and community supports
Provides assistance with calls to various social service agencies, as appropriate
Performs off-site visits (such as, but not limited to: home, hospital, community health centers or other community agencies) as necessary or required
Provides assistance and collaborates with clinical teams in obtaining access to care, DME and services
Directs members/clients to internal departments within Neighborhood as appropriate
Provides comprehensive documentation of all activities and contacts in appropriate software system
Manage a caseload of assigned members
Collaborates with clinical team and schedules visits for licensed staff
Provides cross-coverage as assigned by Manager
Participates in Outreach/Marketing activities as needed and appropriate
Maintains up-to-date knowledge of resources in Rhode Island
Performs other duties as assigned in alignment with care coordination responsibilities
Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood’s Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents