Care Coordinator

AlohaCare; United States; On-site; USD 23,000 - 30,000; Full time

Benefits offered by this job

Low-cost medical insurance

Dental insurance

Vision insurance

401k employer contribution

Paid time off

Referral bonus

Pre-tax transportation and parking

Job summary

AlohaCare is seeking a Care Coordinator to support care management for members and coordinate services with providers and partners across Hawaiʻi. The role emphasizes outreach by phone, plan coordination, and ensuring continuity of care in a compassionate, community-focused setting.

The incumbent will document member needs, assist with utilization and BH reports, and help educate members on available benefits and resources, maintaining accurate records in line with policy and regulatory

Qualifications

• High school diploma or equivalent.
• Associates degree in health service field preferred.
• Strong interpersonal and facilitation skills with effective written and oral communication.
• Professional telephonic etiquette and customer service mindset.

Responsibilities

• Provide outreach to members via phone to discuss care plans and next steps.
• Coordinate care activities with providers, caregivers and community partners.
• Maintain member records and prepare documents for providers and managers.
• Assist with utilization reports, BH reports and quality improvement records.
• Educate members on benefits and resources available.

Skills

Interpersonal skills

Facilitation skills

Written communication

Oral communication

Telephone etiquette

Problem solving

Critical thinking

Customer service

Communication with all levels

Education

High school diploma or equivalent

Associates degree in health service field

Tools

Microsoft Word

Excel

Outlook

PowerPoint

Job description

The Company AlohaCare is a local non profit health plan serving Hawaiis low income residents with free Medicaid and dual Medicare health insurance coverage Our members include children seniors and adults residing on all islands We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care Our approach is to meet the whole person health and social needs of members Through our community partnerships we offer innovative services such as connection to social service agencies Native Hawaiian healing services and in home primary care for qualified members Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all We are Hawaiis third largest health plan and offer a wide network of quality primary care specialists hospitals pharmacies and among many other providers across the state

The Culture

AlohaCare employees have a passion for helping Hawaiis most underserved communities Our caring culture is fundamental to our company wide team approach to providing high quality services We support our employees with a supportive and positive work environment healthy work life balance continuous communication and a generous benefits package AlohaCares leadership empowers and engages its employees by recognizing outstanding job performance and collaboration We share organization wide updates during quarterly All Staff meetings We encourage participation in volunteer and educational opportunities We put a high value on honesty respect and trust building We encourage open door two way and frequent communication AlohaCares comprehensive benefits package includes low cost medical dental drug and vision insurance paid time off 401k employer contribution referral bonus and pretax transportation and parking program

The Opportunity

The Care Coordinator supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of caremember satisfaction is achieved Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically

Primary Duties and Responsibilities

Provides outreach to members via phone to engage members and discuss care planservice plan including next steps resources questions or concerns related to recommended care and ongoing education for the member throughout careservice as appropriateCoordinates care activities based on the care planservice plan and works with healthcare and community providers and partners and memberscaregivers to accommodate changes or progress as neededServes as support on various member andor provider inquiries requests or concerns related to care planservice plansDevelops in depth knowledge of care management services including responding to some complex or escalated issuesCommunicate with care managers practitioners and others as needed to facilitate member services and to ensure continuity of careSupport performing service assessmentsscreenings for members with some complex needs and documents the members care needsSupport documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as neededWork with care management team triaging adjusting and escalating complex requests to managementFollows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standardsAbility to identify needs and make referrals to Case Manager or community care organizationsFollow up with the members who no longer meet the criteria for additional and intensive behavioral health services from the CCS program and who are transitioned back to the base plan for BH services to assist in ensuring transition of care occursPrepare and coordinate letterscorrespondences to members PCPs and providers as requested by the Case Managers SupervisorManagerAssist the SupervisorManager in generating and monitoring utilization UM reports BH reports member service reports HEDIS QI reports and claims resolutionsParticipate in staff meetings and training take minutesattendance and post on BH Share PointAssist in the maintenance of Program related materials received from providers as well as educational materialsAssist the department with claims review and or denial reconciliation when requestedProvide education on benefits and resources availableMay assist with training and development needsComply with all policies and standardsAll other duties assignedAdhere to regulatory compliance and quality guidelines as well as AlohaCare policies and proceduresResponsible for maintaining AlohaCares confidential information in accordance with AlohaCare policies state and federal laws rules and regulations regarding confidentiality Employees have access to AlohaCare data based on the data classification assigned to this job title

Requirements

High school diploma or equivalentMinimum of 1 year of experience in related fieldExperience working in behavioral health care or care coordinationUnderstanding the concepts of care coordination within the managed care field Achieves results builds trust communicate effectively customer and quality focused Strong interpersonal and facilitation skills with the ability to communicate with all levels of the organizationStrong effective and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations Professional telephonic etiquette skillsAbility to solve problems analyze think critically and make good judgments Strong customer service skills and be able to work in a diverse demanding and evolving environment with strong conflict and problem resolution skillsAble to work independently with minimal supervisionAble to effectively work in a fast paced and changing environment manage multiple projects and priorities across multiple teamsprojects and in a matrixed environment Possesses excellent time management and organizational skills; dependable enthusiastic self starting and self motivated Uses time effectively reacts professionally under pressure Data entry experience with a high degree of accuracy and attention to detailWorking knowledge of Microsoft programs Word Excel Outlook and PowerPoint Experience in the operation of general office equipment to include PC faxcopy machine and phone system

Preferred Requirements

Associates degree in health service Field or related field or equivalent combination of education and experienceMinimum of 2 years of work experience as a case manager in a community setting Knowledge of community resources including specialty care behavioral health care resources inpatient and outpatient community resources Mental Physical and Environmental Demands Sedentary Work Exerting up to 20 pounds of force occasionally andor a negligible amount of force frequently or constantly lift carry push pull or otherwise move objects Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met In an office working environmentMay require prolonged sitting up to 4 hoursRequires prolonged operation of a computer workstation including the ability to type for extended periods of time on a keyboard during the scheduled workday

Salary Range 1650 2200 an hour

AlohaCare is committed to providing equal employment opportunities to all applicants in accordance with sound practices and federal and state laws Our policy prohibits discrimination and harassment because of race color religion sex including gender identity or expression pregnancy age national origin ancestry marital status arrest and court record disability genetic information sexual orientation domestic or sexual violence victim status credit history citizenship status militaryveteran status or other characteristics protected under applicable state and federal laws regulations andor executive orders