Job Responsibilities:
· Ensures the responsible delivery of comprehensive services to enrollees.
· Conducts general assessments for supervisor/lead interpretation/evaluation and assignment to case manager / health coach based on results.
· Participates in the interdisciplinary case reviews for collaborative assessment and coordination planning to ensure quality care.
· Proactively engages in delivery of quality management program activities that are the direct responsibility of the Health Services team. Assists in the achievement and ongoing maintenance of accreditations for defined programs.
· Assists Lead, Supervisor and/or Manager in ensuring achievement of contractual financial obligations, including service delivery in a cost effective and efficient manner and through support of budgetary adherence by reporting accurate and timely work hours and expenses incurred during course of position duties.
· Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.
Required Qualifications
· Associate’s degree in health-related field and/or medical assistant training or higher strongly desired.
· Bachelor’s degree in health-related field preferred.
· Minimum of four 4 years current experience in care coordination (field environment preferred).
· Minimum 2-3 years of recent experience in clinical environment, preferably in field delivery.
· Public sector experience, e.g. Commercial / Medicare / Medicaid preferred.
Preferred Qualifications
· Knowledge and familiarity with public sector health coverage systems, e.g. Medicare / Medicaid.
· Knowledge of principles, ethics, and precepts of care management service delivery.
· Knowledge of customer service principles.
· Knowledge of medical terminology.
· Knowledge of regulatory and accreditation standards.
· Strong written and verbal communication skills.
· Strong field and telephonic interviewing skills.
· Strong computer skills, e.g. care management applications, Internet/Web, Microsoft Office (Word, Excel, Access).
· Strong prioritization and organizational skills.
· Ability to demonstrate purposeful and outcomes directed critical thinking within daily operational activities.
· Ability to receive verbal and written feedback in a professional manner and implement performance and productivity improvements as needed.
· Ability to interpret real-time and historical information to inform delivery on overall accountabilities.
