Resource Coordinator

Amerihealth Caritas•,

About The Position

As part of the care coordination team, the Resource Coordinator supports the development of and executes on the outreach strategy in a certain territory for the purposes of influencing health outcomes and member engagement. This position is responsible for establishing and cultivating relationships with members, community stakeholders and providers.

Requirements

Bachelor’s Degree required.
Comprehensive knowledge of Medicaid requirements and plan, policies and procedures.
Knowledge of managed care.

Nice To Haves

Degree in Health Care, Human Services, or Social Work preferred.
Community based care experience preferred.
Previous experience in presenting health education materials to individuals and small groups.
Knowledge and understanding of medical terminology and disease processes.
Ability to effectively communicate preventive health and health management philosophies to member’s and agencies.

Responsibilities

Investigate and resolve member record discrepancies, including name, date of birth, address, phone number, and placement changes.
Lead and coordinate DSS Regional Huddles, including agenda preparation, meeting facilitation, and follow-up activities.
Maintain, monitor, and troubleshoot departmental master spreadsheets and tracking systems.
Manage Placement Change files, including data entry, tracking, reporting, and reconciliation.
Record and distribute huddle meeting minutes and action items.
Maintain and update Group Home and Child Placing Agency (CPA) contact databases.
Manage and update Well-Being Team rosters and distribution lists.
Coordinate system access for new associates, including Medicaid Portal and CAPSS access requests and issue resolution.
Develop, maintain, and update operational resources, including Foster Care FAQs and Genesys process documentation.
Monitor and track members who have not completed required appointments or outreach activities.
Process and coordinate Integrated Care Management (ICM) referrals as requested.
Respond to and manage inquiries from internal staff, DSS, DHHS, providers, and other stakeholders.
Coordinate activities related to Extended Foster Care (EFC) members and communications received from DSS.
Maintain departmental email distribution lists and communication records.
Track, compile, and report daily operational metrics and performance indicators.
Generate and distribute weekly reports of pending member enrollments.
Assist with DSS appointment tracking and reporting.
Monitor and follow up on late or missing Well-Child Visits (WCV) and related documentation.
Support planning and coordination of virtual meetings, trainings, and social engagement events.
Research, document, and resolve medication discrepancies and related member concerns.
Communicate effectively with cross-functional teams to ensure timely issue resolution and accurate data management.
Support continuous process improvement initiatives to enhance operational efficiency and member outcomes.