Care Coordinator

Integrated Resources, Inc ( IRI ); New Mexico; Remote; Full time

Job summary

Integrated Resources, Inc ( IRI ) is seeking a Care Coordinator to conduct home health assessments and support members in navigating their health care plans. This remote position involves local field visits and requires strong communication skills and relevant experience in managed care systems. Ideal candidates will have a background in social work or nursing and a commitment to improving member health outcomes.

Qualifications

• Bachelor's degree in Social Work or Psychology or equivalent experience.
• Experience coordinating member medical needs and analyzing member needs.
• Current state driver license and transportation.

Responsibilities

• Conduct home health assessments and educate members on health care programs.
• Build relationships with members to encourage compliance with care plans.
• Support the clinical team by performing non-clinical functions.

Skills

Knowledge of medical terminology

Verbal and written communications skills

Computer proficiency including Microsoft Office applications

Ability and willingness to travel

Education

Bachelor of Social Work or Psychology

LVN, LPN with 1 year experience in managed care systems

RN

3 years care coordination for a state managed or waiver program

3 years managed care systems experience

Job description

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Integrated Resources, Inc ( IRI ) provided pay range

This range is provided by Integrated Resources, Inc ( IRI ). Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$28.00/hr - $30.00/hr

Direct message the job poster from Integrated Resources, Inc ( IRI )

Lead Recruiter at Integrated Resources Inc.(Scientific/ Clinical/Life Sciences /Pharmaceuticals /Engineering/Healthcare/ Business Professionals)

Location: Remote with some local field visits

Duration: 2+ years (contract to hire)

Looking for candidates in Bernalillo County, Valencia County, Sandoval County, Santa Fe County, San Miguel County, Mora County, Taos County, Cibola County, McKinley County, San Juan County, and Farmington and Colfax County.

NOTE: All our member care coordinators have an expectation to compete in home visits, if they are hired to the nursing facility then they will be expected to visit nursing facilities. There is no real way to know how frequent the visits are, it is 100% dependent on member needs, however, I think most CCs are in the field 3-4 days weekly. There is going to be travel involved depending on the area where the individual lives. Obviously rural areas require further travel; urban areas are less travel.

Basic Function:

This position is responsible for conducting home health assessment, contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities.

Essential Functions:

• Responsible for home health assessments and system updates.
• Perform outreach and follow up attempts to members on their health care plan.
• Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise.
• Inform and educate members on their program, may use supplied scripts.
• Complete records in system by performing data entry.
• Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation).
• Generate appropriate correspondence and send it to member manually, electronically, or telephonically.
• Conduct check-ins with members to review individual care plan goals.
• Maintain production requirements based on established department business needs.
• Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate, manage, and close a case within the platform.
• Receive, analyze, conduct research and respond to telephone and/or written inquiries.
• Process information from member or provider to determine needs/wants and ensure customer questions have been addressed.
• Respond to customer or send to appropriate internal party.
• Notify help desk of system issues.
• Perform data entry function to update customer or provider information.
• Obtain required or missing information via correspondence or telephone.
• May serve as contact for the various groups regarding claims which involve conducting research, obtaining medical records/letters of medical necessity from TMG, reopen or initiate new cases as needed and referring cases to clinicians.
• Support and maintain communications with various in-house areas regarding groups concerns, i.e.: Marketing, Provider Affairs, and SSD.
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Maintain complete confidentiality of company business.
• Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

Job Requirements:

• Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience.
• Knowledge of medical terminology.
• Experience coordinating member medical related needs, aiding members, and analyzing member needs.
• Computer proficiency including Microsoft Office applications.
• Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues
• Current state driver license, transportation, and applicable insurance
• Ability and willingness to travel.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Science, Research, and Health Care Provider

• Industries

  Health and Human Services, Hospitals and Health Care, and Public Health

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