Managed Care Organization Care Coordinator I

Family Health Centers of Southwest Florida Inc•Fort Myers, FL

10d

About The Position

Responsible for coordinating follow-up visits and screening education for patients of all ages using patient information provided by Managed Care Organizations. Outreach is conducted by phone and through established email and text campaigns. The coordinator collaborates with Level II MCO Care Coordinators to support submission of supplemental data to close care gaps and completes hospital follow-up outreach to FHC patients using discharge lists received from Lee Health and other contracted insurance plans. The role may also involve analyzing reports and contacting patients on projects intended to improve healthcare through increased contact and regular visits. The position requires adherence to the Corporate Compliance program, including reporting improper or unethical conduct and violations of applicable laws, regulations, or program requirements. The coordinator applies medical terminology and HIPAA knowledge; documents outreach and patient information in the EHR; educates patients about preventative screenings; provides agency resources; schedules provider evaluation appointments; refers patients to in-house services as needed; and maintains accurate patient records and standardized data. The role also includes attending team meetings and training, contributing to assigned HEDIS pilot programs, and performing other duties as assigned.

Requirements

Minimum 2 years of experience in a primary care setting.
Strong interpersonal skills.
Ability to make patients feel comfortable attending needed appointments through a patient-centered approach.
Ability and willingness to work in a time-limited, structured, solution-focused environment.
Ability and willingness to function independently and proactively in a primary healthcare setting.
Ability to maintain a professional stance if conflicts arise with other staff.
Flexibility to adapt to unforeseen needs or circumstances.
Effective use of the Internet, Excel reports, and EHR systems in the work environment.
Computer skills in word processing, Excel spreadsheets (including editing, filtering, and creating graphs and tables), and presentation software.

Nice To Haves

Bilingual Spanish/English.

Responsibilities

Coordinate follow-up visits and screening education for patients of all ages through phone, email, and text outreach.
Collaborate with Level II MCO Care Coordinators to support submission of supplemental data to close care gaps.
Complete hospital follow-up outreach to FHC patients using external discharge lists.
Participate in report analysis and patient-contact projects aimed at improving healthcare and scheduling regular visits.
Report improper or unethical conduct and violations of applicable laws, regulations, or program requirements.
Apply medical terminology and HIPAA knowledge in the work environment.
Maintain effective working relationships with colleagues, management, and providers.
Use an appropriate, motivating, patient-centered tone when speaking with patients by phone.
Document patient outreach in a timely manner.
Educate patients about preventative screenings and provide applicable agency resources.
Schedule evaluation appointments with providers for patients of all ages.
Use the EHR to accurately document and track patient history.
Maintain accurate, up-to-date patient records and standardized data.
Refer patients to in-house service lines as needed.
Attend and contribute to team meetings and training coordinated by the manager.
Participate in HEDIS pilot programs as assigned.
Perform other duties as assigned.