Member Care Coordinator

Community Care of North Carolina Inc•Cary, NC

About The Position

The Member Care Coordinator is a non-clinician role that works with Care Management and/or quality improvement staff to support multidisciplinary patient care and organizational performance goals. These goals include closing care gaps, reducing hospitalizations, readmissions, emergency department utilization, and per-member-per-month costs. The coordinator may work remotely within regions across North Carolina and/or onsite at Community Care Physician Network practices. The coordinator may work directly with members to help improve health outcomes, support care coordination and health system navigation, and connect people with local resources. The role also supports office systems and Care Team operations, and may work with assigned practices and the Provider Relations Representative/Quality Improvement Team to address and close care gaps.

Requirements

High school diploma or GED.
At least 2 years of experience in a health care setting; the posting specifies 2–4 years minimum experience.
Knowledge of and experience working in patient or clinical data systems.
Computer skills, including experience with office software and the internet.
Knowledge of state and federal benefits systems.
Excellent oral and written communication skills.
Proficient Motivational Interviewing skills.
Organizational and time management skills.
Sensitivity to cultural diversity, language barriers, health literacy, and educational levels.
Knowledge of medical terminology.
Ability to respond positively to change and willingness to learn new ways to accomplish work activities and objectives.
Ability to shift strategy or approach in response to situational demands.

Nice To Haves

A 2- or 4-year degree in a health-related field.
Bilingual ability.
Experience with MS Office software.

Responsibilities

Receive and document referrals from various sources in the care management documentation platform.
Conduct outreach and engagement, and schedule members for Care Managers.
Verify member eligibility and demographic information.
Complete screenings as needed.
Assist with mailing educational materials, consent forms, and other documents to members.
Assist with referrals and tasks delegated by the Care Management or program team.
Provide information about access to and coordination of resources.
Assist members with care coordination and health care system navigation.
Provide culturally appropriate health education, general education, and social support.
Advocate for members.
Identify care gaps and conduct outreach to help close them as requested.
Help practices submit supplemental data to health plans documenting gap closure, and assist with scheduling medical appointments and transportation as needed.
Help pull Care Gap, Recommended Actions, and High Risk reports.
Assist with addressing Social Determinants of Health as needed.
Access multiple electronic health record systems to obtain and upload documents into the care management platform; access hospital data or electronic medical record systems as necessary.
Meet productivity and role expectations.
Collaborate with the Care Team to address barriers and improve process efficiency.
Follow CCNC privacy and security policies and comply with department guidelines, company policies, and HIPAA regulations.
Attend departmental and corporate meetings, local and regional trainings, and other required events.
Uphold CCNC goals, objectives, and standards.
Perform other duties as requested.