Utilization Management Coordinator

Heart City Health • Elkhart, IN

7d

About The Position

The Utilization Management Coordinator works with patients referred for assistance in accessing and utilizing health care resources due to their complex chronic illness and preventative screenings and improves health outcomes through coordinating care, educating patients, building trust between patients and medical practitioners, and enhancing communication and continuity of care.

Requirements

• Medical Assistant Course completion required.
• Excellent communication skills; active listening as well as written and oral comprehension/communication skills; Gives full attention to what individuals are saying, understands the point being made, asks appropriate questions to gain better knowledge of situation(s) and repeats information to ensure understanding; Public speaking skills required; Bilingual (English/Spanish) language skills are helpful
• Excellent customer service skills; actively seeks ways to assist internal and external customers within the scope of assigned duties
• Greets professionally, uses name, and ensures the patients comfort and answers questions as able.
• Good computer skills; Outlook, Windows, Microsoft Office applications; EMR exposure preferred
• Good time management skills, self-evaluates the use of time and understands how others may be affected
• Cultural diversity awareness and skills; respects all people regardless of race, nationality or social standing
• Ability to work independently (self-motivating) and as a team member
• Ability to develop a collaborative therapeutic alliance with individuals and make accurate professional judgments
• Ability to build and maintain effective working relationships with co-workers, providers, managers, patients and vendors
• Familiarity with local community resources for patients with chronic disease
• Knowledge of health promotion and disease prevention methods related to routine health care and teaching methods designed to address the needs of patients with chronic, disabling health conditions
• Familiarity with Patient-Centered, Medical-Home concepts
• Problem sensitivity skills; empathetic/understanding
• Deductive reasoning and problem-solving skills
• 1 to 2 years' clinical medical office experience preferred

Nice To Haves

• Medical Assistant Certification (CCMA/RMA) preferred or must be eligible to take exam
• EMR exposure preferred
• Bilingual (English/Spanish) language skills are helpful

Responsibilities

• Performs intake assessment which includes obtaining and reviewing prior medical records and medical or program-related information and assessing cognitive/verbal skills and needs and identifying barriers to accessing healthcare
• Understands laboratory testing, immunizations, TB skin testing and referral for preventive health needs as indicated per disease management protocols
• Monitors patients frequently for changes in health status after recent hospitalization
• Routes calls to triage and facilitates a response to urgent telephone calls, requests or visits from assigned patients
• Assists with arranging supportive services as needed
• Assist patient with goal-setting to achieve behavioral or health change
• Participates in regular staffing meetings focused on coordinating patient care within an interdisciplinary team, keeping the team updated on patients' conditions and circumstances by utilizing morning huddles.
• Consults with other health care team members to coordinate the services of patient education, preventive care and disease management
• Coordinates ER and IP Transition of Care
• Communicates with providers patient needs for patients being seen that day.
• Other duties as assigned
• Teaches, counsels and follows-up with assigned patients on health issues relevant to his or her care
• Performs individualized assessment of patients' educational needs and provide tools to assist patients in managing their disease(s) effectively
• Provides individual and family educational interventions including self-management goal-setting, counseling and training on the habits, lifestyle changes, supplies and tools necessary to manage their disease
• Provides individual counseling on office procedures and importance of a primary care medical home and other health issues. Provides referrals for eligibility of programs and services.
• Assists in the development and maintenance of a library of educational resources including written materials and videos, on related health issues
• Serves as a consultant to the rest of the health care team for educational resources, reviewing them for language, cultural competency and reading level
• Assists in gathering and compiling data to direct the most effective use of educational interventions
• Follows-up with patients to assess whether educational objectives are met and determine need for refresher interventions
• Holds all patient Protected Health Information (PHI) and other patient personal information as well as agency association information in confidence, in accordance with HIPPA and Heart City policy
• Participates in quality assurance and improvement meetings, special projects, observances and/or activities that advance the mission, goals and objectives of Heart City Health
• Other duties as assigned

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed
• Number of Employees: 51-100 employees