On-Site Care Coordinator (RN) - Rock Hill, SC

CHS•Rock Hill, SC

12h•Remote

About The Position

This is a work-from-home position with travel required within Rockhill, Fort Mill, Indian Land, SC territory/York, SC County. Mileage is reimbursed for travel. The On-site Care Coordinator is a Registered Nurse who provides care coordination, education and outreach services on-site (various locations including home) to Medicaid members in the Medically Complex Children’s Waiver program. This position requires licensure as a Registered Nurse in the State of SC.

Requirements

A Minimum of three (3) years of recent clinical pediatric experience is required
A bachelor’s degree in a health-related field is strongly preferred
Previous work experience with a Medicaid program is preferred
Bilingual (Spanish) is preferred
Ability to travel locally with a valid drivers’ license and automobile insurance insurance
Initial TB negative test and completion of a TB questionnaire, yearly
Certified Case Management (CCM) Certification is preferred
Current RN licensure in states where business is conducted
Current BLS certification
Proficiency using software programs such as MS Word, PowerPoint, Excel, Outlook and Adobe
Absolute confidentiality: Employees must not disclose PHI to unauthorized individuals under any circumstances.
Secure environment: A private, locked workspace must be maintained to prevent exposure of PHI to family members, visitors, or others.
Company-approved technology only: All work must be must be performed on secure, company-issued devices using encrypted connections (VPN required).
You will be required to complete HIPAA training upon hire and annually thereafter.
Any breach of confidentiality or unauthorized disclosure of patient information may result in disciplinary action up to and including termination and may carry legal consequences under state or federal law.
Maintains strict confidentiality of client, company and personnel information
Demonstrates a strong commitment to the mission and values of the organization
Adheres to company attendance standards
Completes all annual training assigned by the deadline for completion
Will demonstrate successful completion and compliance with all policies and procedures, to be assessed during quarterly performance reviews
Criminal background, OIG, and South Carolina Exclusion list checks must remain in good standing
South Carolina Law Enforcement Division Check must be completed upon hire and every 5 years thereafter
Will abide by the Ethical Code of Conduct set forth by the company, to be reviewed and signed yearly
You agree to maintain the confidentiality of all proprietary and non-public information obtained during your employment. This includes, but is not limited to, company records, financial data, client and vendor information, business strategies, and any other information not generally known outside the Company. You may not use or disclose such information during or after your employment, except as required in the performance of your duties.
All company property and materials must be returned upon separation of employment.

Nice To Haves

A bachelor’s degree in a health-related field is strongly preferred
Previous work experience with a Medicaid program is preferred
Bilingual (Spanish) is preferred
Certified Case Management (CCM) Certification is preferred

Responsibilities

Upon referral, perform an initial medical eligibility assessment to determine eligibility for the program.
If qualified, perform an initial, in-home, level of care assessment to include the completion of all required documentation.
Fulfills requirements established by SCDHHS to complete an annual home visit, three in person quarterly visits, and monthly contact calls during months a visit is not required.
Ensuring the information contained in the system of record is accurate and complete.
Provides members and their authorized representatives with education required to care for members and arranges appropriate education services, if necessary.
Develops case specific care plans/service plans and presents to the primary care provider for approval and/or revision; submits care plan to DHHS for approval.
Collaborate with the Care Advocate Team to ensure all required services, communications, documentation, and ancillary needs are addressed.
Maintains availability to members, their authorized representatives, and providers to coordinate any required services.
Serve as a member advocate, attending educational advocacy meetings, team conferences, etc. as requested and available.
Addresses and identifies complaints, grievances, or concerns and escalates to the appropriate stakeholder, whens necessary.
Develops disaster plan, identifies availability of advanced directives, needs for ancillary services, specialty services and community services.
Upon member ineligibility, age out, or other circumstance in which disenrollment from the program becomes necessary, complete all needed activities to ensure continuation of care and communicate with all stakeholders to ensure an uninterrupted transition of care.
Serve as a mandated reporter.
Will have access and manage PHI in accordance with federal and state requirements (HIPAA, HITECH).