Clinical Coordinator - Case Management

Brighton Health Plan Solutions, LLC • Chapel Hill, NC

12d

About The Position

Brighton Health Plan Solutions (BHPS) provides Case Management / Medical Management services to its clients. Clinical Coordinator facilitates case management by performing intake and clinical data collection & entry, clinical intake screening assessment, and effectively communicating with Nurse Case Managers. The Clinical Coordinator reports to the Manager, Case management.

Requirements

• Bachelor’s degree preferred but not required.
• LPN/LVN license required.
• HS diploma or GED is required.
• Strong skills in medical record review.
• Excellent customer service and communication skills.
• Ability to think critically, define problems, obtain data, and establish facts.
• Ability to work proficiently on a computer (PC) with working knowledge of Microsoft Word and Excel.
• Excellent data entry skills.
• Self-starter with strong organizational skills, the ability to work independently, and complete tasks as identified and/or assigned.
• General Knowledge of HIPAA Confidentiality Laws

Nice To Haves

• Familiarity with medical terminology a plus.
• Ability to work in a database environment a plus.
• Experience in learning various software programs a plus.

Responsibilities

• Answer and handle phone calls within required time frames.
• Mail/email correspondence, resources, and information to members.
• Collect clinical and demographic data upon notification from patient/patient representative, or physician; verify member eligibility.
• Create cases within Case Management system in accordance with departmental workflows, policies, and procedures.
• Interact telephonically with members and providers and accurately acquire and relay clinical information about medical status, diagnoses, and future care needs.
• Conduct initial intake clinical assessment to determine what acuity/outreach is needed and reassign to RN, if needed, per process.
• Adhere to established quality assurance standards and all BHPS policies and procedures.
• Discuss and document any concerns, complaints and/or issues with direct supervisor.
• Demonstrate the Brighton Values, and a kind, caring, sympathetic and positive attitude with all customers including fellow employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 11-50 employees