Member Care Coordinator

Community Care of North Carolina•Cary, NC

About The Position

The Member Care Coordinator is a non-clinician role that collaborates with Care Management and quality improvement staff to support a multidisciplinary approach to patient care. The role helps meet performance goals, including closing care gaps and reducing hospitalizations, readmissions, emergency department utilization, and per-member-per-month costs. Coordinators may work remotely within regions or onsite at Community Care Physician Network practices. They may assist members directly with improving health outcomes, support care teams and office operations, and work with assigned practices on care-gap closure in collaboration with Provider Relations and the Quality Improvement team.

Requirements

High school diploma or GED.
At least 2–4 years of experience in a health care setting.
Knowledge of and experience working in patient or clinical data systems.
Computer skills, including use of 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 learn new ways to accomplish work activities and objectives.
Ability to shift strategy or approach in response to situational demands.
Ability to use office equipment, a computer, keyboard, and phone, with or without assistive devices.

Nice To Haves

A two- or four-year degree in a health-related field.
Bilingual ability.
Experience with Microsoft Office software.

Responsibilities

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