BusinessOperations – Care Coordinator II Care Coordinator II Position Available In Broward, Florida

BusinessOperations – Care Coordinator II Care Coordinator II#25-55200
Sunrise, FL
All On-site Job Description

Job Description:

“

Position Purpose:

Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities. “Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service May support performing service assessments/screenings for members and documenting the member’s care needs Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager Provide education on benefits and resources available
Performs other duties as assigned Complies with all policies and standards”

Education/Experience:

Requires a High School diploma or GED
Requires 1 – 2 years of related experience”
Comments for

Vendors:

EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.” =======
Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):
Both teams would be supporting pediatrics
Concierge team
Taking calls from parents and caregivers anytime the caregiver is experiencing any unexpected issue in the care of the child (night nurse called off, medication not being filled at pharmacy, delivery of medical supplies delayed, etc.)
Taking the information provided from the call and working with the caregiver / parent to find resolution.

NOT A CALL CENTER

Describe the performance expectations/metrics for this individual and their team:
No current metrics
Supporting 800 – 1000 members (small population)
Calls are based on volume.
Most important note would be that the team is looking to deliver quality care to each caregiver / parent. PC will not be evaluated based on number of calls but based on customer service provided to parent / caregiver.
White Glove Service
Tell me about what their first day looks like:
Centene IT Training
Training completed through Shared Service training course (4 weeks)
HR / Compliance
TruCare training, Medicaid (FL) training
All training will be held online.
What previous job titles or background work well in this role?
Call center background, healthcare experience, Front desk / receptionist within a healthcare setting, customer service within a healthcare setting
What makes your team/department/culture special that you would like candidates to know?
Membership that the team supports is for pediatrics with complex medical needs.
These members meet the criteria to have 1:1 nursing at home.
Serve medical issues amongst peds patients (complex situations)
Team is looking for someone who can act in a prompt, empathetic matter.
Ensuring that the families and children are taken care of with the most professional and member focused care.
New hires will get to build a relationship with the members and be apart of their journey.
What red flag(s) would cause you to immediately disqualify a candidate?
Not looking for a resume that is “perfection” but to the eye issue (messy, not organized, spelling, grammar)
Not demonstrating problem solving skills (vendors please ensure this is noted on resume )