Care Coordinator, SW DD – Hope

Job not on LinkedIn

🔥 0 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 the 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 plan • Provide member support access in addressing social determinants of health, such as facilitating access to exercise opportunities and nutritious food • Verify insurance coverage and benefits for patients, ensuring accurate and up-to-date information is obtained and documented • Conduct utilization reviews to evaluate the medical necessity and appropriateness of requested services, ensuring compliance with established guidelines and policies • Collaborate with insurance companies and healthcare providers ensuring availability and quality of services • Facilitate coordination with diverse healthcare providers for diagnostics, ambulatory care, and hospital services • Serve as a point of contact for members, addressing their questions, concerns, and complaints related to managed care services, and advocating for their needs within the organization • Encourage initiatives aimed at improving the health of patients and their communities, including outreach efforts, quality improvement initiatives, and patient panel management • Coordinate community-based management of medication therapy • Ensure compliance with applicable laws, regulations, and contractual obligations related to managed care services • Maintain accurate and complete documentation of all interactions, authorizations, and communications • Ensure compliance with the PCSP and assist with any resources needed or barriers to accessing treatment • Identify opportunities for process improvement and efficiency enhancement in managed care operations • Propose and implement strategies to optimize service delivery and enhance patient satisfaction • Collaborate with both external and internal stakeholders to ensure the highest level of 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 • The ability to occasionally lift objects weighing up to 15 pounds is required