Centers Plan for Healthy Living

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Care Coordinator - Bronx

Care Coordinator - Bronx

ID 
2017-1235
# of Openings 
1
Job Locations 
US-NY-Bronx
Posted Date 
9/27/2017
Category 
Care Management

More information about this job

Overview

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Join the excitement in support of our MLTC and Medicare Advantage Plan businesses!

Centers Plan for Healthy Living (CPHL), is a Managed Care Organization servicing members with Medicare and/or Medicaid.  Our goal is to provide members and all those involved in their care with the guidance and health plan choices they need for healthy living. CPHL is committed to providing quality, coordinated health care to some of the most honored and yet still vulnerable members of our community.

 

Responsibilities

JOB SUMMARY:

The Care Coordinator works within a multidisciplinary care team to help assist with the care of members enrolled in our Managed Long Term Care program to facilitate, schedule and arrange a variety of treatment and healthcare plans.

   

PRIMARY RESPONSIBILITIES:

  • Assists in scheduling of enrollment and ongoing member visits for the field staff which includes tracking and rescheduling of canceled appointments.
  • Receives inbound telephonic calls from member and escalates calls or issues to appropriate team members when necessary.
  • Generates member correspondence and handles mailings as needed.
  • Coordinates communication between field clinical staff and members’ physician(s)
  • Assists with preauthorization of services for members.
  • Documents daily calls and follows care coordination documentation guidelines which includes but are not limited to: documentation of problems, interventions and outcomes.
  • Act as liaison and member advocate between the member/family, physician(s) and the care team to ensure timely and effective communication in regards to the member’s care.
  • Participates in case round meetings and on-going education activities
  • Ensures that all job responsibilities are carried out in compliance with CPHL and State and Federal regulations.
  • Other assigned duties

Qualifications

Education and Experience:

  • Required: HS Diploma
  • Preferred:  Bachelor’s Degree

Required Qualifications:

  • 2 years customer services experience
  • Strong written and verbal communication skills
  • Computer proficiency
  • Strong multi-tasking abilities

Preferred Qualifications:

  • Experience working within a managed care environment
  • Experience working with the geriatric population
  • Bilingual in Creole, Arabic or Korean

Certifications/Licensure:

  • Required:   None

Physical Requirements:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

  • Must be able to operate a computer and telephone

The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification.  They should not be construed as an exhaustive list of all responsibilities, duties and skills required.