Community Care Coordinator (44286)

Neighborhood Health Plan of Rhode Island•Smithfield, RI

23h•Onsite

About The Position

The Community Care Coordinator (CCC) works collaboratively with the health care team to manage and coordinate care for members that have social needs in order to ensure quality and cost-effective patient-centered care. This position also works directly with members/clients as well as with staff, managers, internal and external customers.

Requirements

Associates Degree in human service related field preferred or equivalent years of background and experience to equal degree
Three (3) to Five (5) years experience in medical or social services setting or minimum of six (6) months experience working in a position at Neighborhood Health Plan of Rhode Island
Experience working with the needs of individuals with behavioral health and/or long term care needs
Strong oral and written communication skills
Strong customer service orientation
Strong interpersonal skills
Strong organizational skills
Ability to problem solve and work independently
Strong collaborative skills and teamwork values
Computer literacy with windows based programs
Sound judgment
Strong time management skills
Ability to keep accurate records and prepare reports
Ability to work with minimal supervision
Flexible schedule including evenings and weekends
Ability to travel for work, must have access to reliable transportation and/or valid drivers license and proof of insurance

Nice To Haves

Clinical specialty experience
Knowledge of community social service resources, State agencies and the state Medicaid program
Knowledge of medical terminology
Knowledge/expertise in substance use and/or mental health
Bilingual

Responsibilities

Under the direction of a Medical Case Manager, performs ongoing care coordination activities.
Conducting outreach
Completing HRA and initial health screening
Providing telephonic initial screen of non-medical needs, coordinates services and makes appropriate referrals
Providing information to members/clients and/or their families regarding social and community support
Assist with calls to various social service agencies as appropriate
Off site visits (such as but not limited to home, hospital or community health centers or other community agencies) as necessary or required
Supporting members to obtain access to care and services and making appointments
Aid in obtaining medically necessary DME
Directing members/clients to internal departments as appropriate
Managing a case load of identified and/or assigned members
Providing comprehensive documentation of all activities and contacts in CMAQE or appropriate software system
Assist Medical and/or Integrated Care Managers in coordinating community resources as appropriate
Participate in the development and maintenance of community resource database
Calculate cost savings that may result from interventions, where an alternative level of care, service or resource has been identified and/or arranged
Responsible for, identify, and, pursue opportunities for professional development
Recommend and participate in the development of program improvements and QI activities
Serve as resource to respond to questions from ancillary departments within Neighborhood
Participate in community events and project as assigned
Provide cross coverage as assigned by Lead and/or Manager
Participate in Outreach/Marketing activities as needed and appropriate
Maintain up-to-date knowledge of resources in Rhode Island
Other duties as assigned
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