Integrated Duals Program Coordinator II

CareSource•Dayton, OH

About The Position

The Integrated Duals Program Coordinator II supports care coordination and engagement activities while serving as an advanced resource across multiple teams. This role not only ensures timely, effective, and member centered services but also provides elevated support through documentation oversight, coordination triage, and different assistance to the supervisor by managing complex escalations and mentoring program coordinator I staff, this position strengthens continuity of care and promotes efficiency across care coordination. Essential Functions: Understand, demonstrate, and model complex and comprehensive person-centered thinking Perform all duties of an Integrated Duals Program Coordinator I, including outreach to members and providers, coordinating schedules and services, documenting care coordination activities, and ensuring compliance with contractual and regulatory standards. Act as first point contact of escalation for complex or urgent member and provider needs, coordinating responses and involving the supervisors and collaborating with cross functional teams to ensure timely resolution of high priority requests Mentor and support Integrated Duals Program Coordinator I's and new staff by answering questions, sharing best practices, and ensuring consistency in documentation and workflow processes Maintains accurate and timely documentation and internal systems to ensure visibility across teams and continuity of service, while also ensuring ongoing collaboration and communication with the internal clinical team Serves as the primary point of contact for managing complex and urgent escalations while providing warm transfers, real time responses, and downstream resolution coordination as required. Coordinates provider and member scheduling efforts, supports high-volume outreach campaigns, and ensures task completion across multiple systems. Continuously and proactively engage members through participating in information collection and assertive outreach which includes via telephone calls Identify potential social support or community-based needs and initiates nonclinical referrals and coordination with care managers Monitors service delivery to ensure appropriateness of care and compliance with any waiver, including the most complex Maintain current and accurate documentation of contacts, case notes, referrals, and assessments in the electronic record according to current accreditation and compliance guidelines Document care coordination activities and member response in a timely manner according to standards of practice and CareSource policies regarding professional documentation Look for ways to improve the process to make the members experience with CareSource easier and shares with leadership to make it a standard, repeatable process Performs any other job related duties as requested.

Requirements

High School or GED required
Three (3) years of experience in healthcare required
Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
Ability to communicate effectively with a diverse group of individuals
Ability to multi-task and work independently within a team environment
Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
Strong advocate for members at all levels of care
Strong understanding and respect of all cultures and demographic diversity
Ability to interpret and implement current research findings
Awareness of community & state support resources
Critical listening and thinking skills
Decision making and problem-solving skills
Strong organizational and time management skills
Trauma informed training

Nice To Haves

Bachelor's degree in a social science or healthcare related field preferred
Four (4) years of experience in healthcare preferred

Responsibilities

Understand, demonstrate, and model complex and comprehensive person-centered thinking
Perform all duties of an Integrated Duals Program Coordinator I, including outreach to members and providers, coordinating schedules and services, documenting care coordination activities, and ensuring compliance with contractual and regulatory standards.
Act as first point contact of escalation for complex or urgent member and provider needs, coordinating responses and involving the supervisors and collaborating with cross functional teams to ensure timely resolution of high priority requests
Mentor and support Integrated Duals Program Coordinator I's and new staff by answering questions, sharing best practices, and ensuring consistency in documentation and workflow processes
Maintains accurate and timely documentation and internal systems to ensure visibility across teams and continuity of service, while also ensuring ongoing collaboration and communication with the internal clinical team
Serves as the primary point of contact for managing complex and urgent escalations while providing warm transfers, real time responses, and downstream resolution coordination as required.
Coordinates provider and member scheduling efforts, supports high-volume outreach campaigns, and ensures task completion across multiple systems.
Continuously and proactively engage members through participating in information collection and assertive outreach which includes via telephone calls
Identify potential social support or community-based needs and initiates nonclinical referrals and coordination with care managers
Monitors service delivery to ensure appropriateness of care and compliance with any waiver, including the most complex
Maintain current and accurate documentation of contacts, case notes, referrals, and assessments in the electronic record according to current accreditation and compliance guidelines
Document care coordination activities and member response in a timely manner according to standards of practice and CareSource policies regarding professional documentation
Look for ways to improve the process to make the members experience with CareSource easier and shares with leadership to make it a standard, repeatable process
Performs any other job related duties as requested.