Managed Care Organization Care Coordinator I

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

About The Position

The Managed Care Organization Care Coordinator I coordinates 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 role works collaboratively with Level II MCO Care Coordinators to support supplemental data submissions and close care gaps. It also assists with hospital follow-up outreach to FHC patients using discharge lists from Lee Health and other contracted insurance plans. Coordinators may participate in report analysis and other patient-contact projects designed to improve patient health through increased contact and regular visit scheduling. The role also follows the Corporate Compliance program by reporting improper or unethical conduct and violations of applicable laws, regulations, or program requirements.

Requirements

At least 2 years of experience in a primary care setting.
Strong interpersonal skills.
Ability to use a patient-centered approach that helps patients feel comfortable attending needed appointments.
Ability and willingness to work in a time-limited, structured, and solution-focused environment.
Ability and willingness to work independently and proactively in a primary health care setting.
Ability to maintain a professional stance when 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

Apply knowledge of medical terminology and HIPAA regulations.
Build and maintain effective working relationships with colleagues, management, and providers.
Use an appropriate tone and language during patient calls to encourage follow-up appointments and support patient satisfaction.
Document patient outreach in a timely manner.
Educate patients about preventative screenings.
Provide patients with applicable agency resources.
Schedule evaluation appointments with providers for patients of all ages.
Use Electronic Health Records (EHR) accurately to document and track patient history.
Maintain accurate, current records and standardized patient data.
Refer patients to in-house service lines as needed.
Assist with hospital follow-up calls to FHC patients using external discharge lists.
Attend and contribute to team meetings and training coordinated by the manager.
Participate in assigned Healthcare Effectiveness Data and Information Set (HEDIS) pilot programs.
Report improper or unethical conduct and violations of applicable laws, regulations, or program requirements.
Perform other duties as assigned.