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Care Coordinator - SCO

Qualifications:

Education: Associate's degree in Healthcare, Nursing, and Social Work or a related area or equivalent relevant work experience desired. Experience: 2 years of office experience, specifically in either a high volume data entry office, customer service call center, or health care office administration department. Preferred/Desirable: Experience with FACETS or other healthcare database. Experience with Health Plan Utilization / Claims departments. Prior customer service experience. Bilingual skills, fluency in Spanish. Experience in working with the geriatric/elder population. Competencies, Skills, and Attributes: Strong Motivational Interviewing skills. Strong oral and written communication skills. Bilingual preferred. Ability to effectively collaborate with health care providers and all members of the PCT. Demonstrated strong organizational and time management skills. Able to work in a fast paced environment and multi task. Experience with Microsoft Office application, particularly MS Outlook and MS Word and other data entry processing applications. Knowledge of medical terminology strongly preferred. Knowledge of community resources strongly preferred. Attention to detail. Strong computer skills. Strong phone skills. Highly organized.

Responsibilities:

In this role, the Care Coordinator, Senior Care Options (SCO) will perform telephonic outreach to durable medical equipment (DME) vendors to order DME for our SCO Enrollees. The Care Coordinator will work closely with SCO care managers in assisting with implementing community resources. The Care Coordinator will reach out to Providers for Enrollee care plan submission and prescription requests. The Care Coordinator will establish Enrollee cases within the care management documentation system, generate letters, and identify, facilitate, coordinate with the SCO care manager for Enrollee services that enhance healthcare access and delivery by assisting in the coordination of SCO services that provide for basic needs such as education, housing, healthcare, legal, transportation and counseling assistance. The Care Coordinator will maintain current knowledge of the Aging Services Access Points (ASAPS) and community-based resources for referral and linkage to Enrollee's needs. The Care Coordinator will maintain the SCO department electronic mailbox for faxes, prescriptions, care plans and outside vendor requests. The Care Coordinator will be a part of the SCO Primary Care Team (PCT) that is led by the Care Manager for SCO and includes the Primary Care Physician and other Providers, the ASAPS, the Geriatric Supports Services Coordinator (GSSC), Beacon Behavioral Health Strategies staff, other non-clinicians, pharmacists, and others. The Care Coordinator will provide support of the PCT, as requested by the Care Manager. The Care Coordinator will document in the care management documentation system. The Care Coordinator may perform face to face visits/meetings with the PCT and/or the Enrollee, or with community agencies, per the request of the Care Manager for SCO. Key Functions/Responsibilities: Assesses Enrollee needs and coordinate with the SCO care managers. Tracks down Enrollee phone numbers and addresses. Sends information packets to Enrollees containing health information relative to the Enrollee's identified conditions and needs. Maintains current knowledge of ASAP and community resources for referral and linkage to Enrollee's needs. Participates in group meetings to ensure policies, procedures, and work flows are up to date and advises on revisions needed. Participates in PCT meetings, as requested. May perform face to face visits with Enrollees, or with the PCT or community agencies, as requested by the Care Manager. Facilitates Enrollee needs by collaborating with the care manager and partners with providers such as Mass Health, clinical vendors, ASAPS, GSSC's, and primary care and specialty practices. Completes documentation in the medical management information system [CCMS] in a timely manner and in keeping with contractual requirements, internal policy and accreditation standards. Complies with established metrics for performance, adheres to documentation and work flow standards and utilizes other department specific tracking tools. Triages cases to the SCO clinical care management staff, other departments, contracted vendors and providers, as appropriate. Participates as assigned in answering calls on the care management 800 line. Maintains HIPAA standards and confidentiality of protected health information. Reports critical incidents and information regarding quality of care issues. Serves and participates in pertinent committees and meetings as needed. Assists with new staff training. Regular and reliable attendance is an essential function of this position.