Care Coordinator – Central DD

Job not on LinkedIn

🔥 10 minutes ago

🇺🇸 United States – Remote

💵 $1 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Empower Healthcare Solutions

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2017

🏥 Healthcare

🌍 Social Impact

Healthcare • Social Impact

Empower Healthcare Solutions is a care coordination and community-based health services organization serving individuals with behavioral health needs and intellectual or developmental disabilities (IDD). It partners with providers, advocates, families, and community resources to develop person-centered plans of care, address functional and clinical needs, and help members navigate medical, behavioral health, and developmental disability systems. Empower’s model focuses on delivering the right care in the right setting at the right time to improve health outcomes and manage total health care costs so members can live fuller, healthier lives at home and in their communities.

📋 Description

• Oversee and facilitate coordination of managed care services, including verifying eligibility, managing referrals, and obtaining authorizations for medical procedures, treatments, and services • Deliver personalized health education and coaching to members based on identified concerns outlined in treatment and service plans • Support members in addressing social determinants of health, including facilitating access to exercise opportunities and nutritious food • Verify insurance coverage and benefits for patients and maintain accurate information • Conduct utilization reviews to evaluate medical necessity and appropriateness of requested services • Collaborate with insurance companies and healthcare providers to ensure availability and quality of services • Coordinate with diverse healthcare providers for diagnostics, ambulatory care, and hospital services • Serve as a point of contact for members, addressing questions, concerns, and complaints and advocating for their needs • Encourage health improvement initiatives, outreach efforts, quality improvement initiatives, and patient panel management • Coordinate community-based management of medication therapy • Ensure compliance with applicable laws, regulations, contractual obligations, and the PCSP • Maintain accurate and complete documentation of interactions, authorizations, and communications • Identify opportunities for process improvement and efficiency enhancement • Propose and implement strategies to optimize service delivery and enhance patient satisfaction • Collaborate with external and internal stakeholders to ensure service efficiency

🎯 Requirements

• High School diploma and One (1) year experience in the mental health field • Bachelor's degree in a relevant field such as healthcare, social work, Psychology or social services and other healthcare related field preferred • Knowledge of managed care principles, processes, and regulations • Familiarity with health insurance terminology, coverage, and benefit structures • Strong organizational skills with the ability to manage multiple tasks simultaneously • Excellent communication and interpersonal skills to effectively collaborate with internal and external stakeholders • Detail-oriented and ability to maintain accurate records and documentation • Proficiency in using computer systems and software applications relevant to managed care operations • A valid driver's license and up to date automobile insurance must meet the minimum requirement in your state • Must be able to drive and perform quarterly visits to their members • Prolonged periods of sitting at a desk and working on a computer • Ability to occasionally lift objects weighing up to 15 pounds

🏖️ Benefits

• Fully remote work arrangement • Up to 25% travel percentage • Reasonable accommodations under the Americans with Disabilities Act (ADA), where medically and reasonably feasible