Transitional Care Services Care Coordinator II

L.A. Care Health Plan•Los Angeles, CA

About The Position

The Transitional Care Services (TCS) Care Coordinator II is responsible for outreach to providers, facilities, and others to promote members’ optimal health and well-being by helping them navigate and access health services when transitioning between care settings. This position coordinates the flow of information between the TCS Community Health Worker (CHW), member, other health plan staff, provider, and medical group and discharge facility. The position supports the coordination of member care as instructed by the Transitional Care Services (TCS) program requirements including the reinforcement of follow up provider appointments, coordination of transportation and Durable Medical Equipment (DME); linking member to Community Supports, Managed Long Term Supports and Services, Doula, health education information and other community resources to address the Social Determinants of Health (SDoH). The position is responsible to ensure the contractual and regulatory requirements and timelines are met by maintaining accurate documentation and following up with the member and provider as needed. In addition, this position is assigned projects to support the department in meeting its regulatory and contractual requirements, such as running reports, data validation, quality checks and other projects. The position assists with the communication and coordination between programs and maintains confidentiality when communicating member information.

Requirements

High School Diploma/ or High School Equivalency Certificate
At least 6 months of experience in an administrative and/or customer service role in a health care/health services setting.
Knowledge of medical terminology.
Strong verbal and written communication skills.
Proficiency in Microsoft Office with a high level of accuracy.
Ability to work in multiple systems/databases.
Excellent organizational, and time management skills.
Detail-oriented and a team player.
Excellent customer service skills with compassion and empathy.
Ability to demonstrate sensitivity and respect for the opinions, perspectives, customs, and individual differences of others.
Ability to value diversity of people and ideas, as well as interact with people from a wide range of backgrounds.
Ability to be flexible, open-minded, listen to and consider others’ viewpoints.
Ability to work well and develop effective relationships with diverse personalities.
Physical Requirements: Light

Nice To Haves

Associate's Degree
2 years of experience as a Medical Assistant or similar role.
1 year of experience processing authorizations at a managed care/health plan setting.
Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese
Certified Medical Assistant (CMA)
Motivation Interviewing

Responsibilities

Responsible for the time sensitive processes for initiating cases, managing referrals to the department, appropriate documentation, routing of information, performing computer data input, faxing, emailing, filing of confidential member information, and maintaining activity logs etc. (50%)
Conducts telephonic outreach calls to discharge facilities, providers, and medical groups. Consults and collaborates with the TCS CHW to set up provider/specialist appointments and follow up. (10%)
Collaborates with team members and health plan staff to coordinate services for members. (10%)
Provides administrative assistance to ensure compliance with the TCS case tracking and closing out within the 30 day time frame. (10%)
Initiates follow up calls to Community-Based Organizations and other internal departments to confirm linkages to appropriate resources. (10%)
Performs other duties as assigned. (10%)