Care Worker

Integrated Resources Inc.; Orange (CA); On-site; USD 40,000 - 55,000; Full time

Job summary

A leading healthcare organization seeks a Care Worker to facilitate workflows and support clinical team operations in care coordination. The role involves assisting with community resources, participating in operational activities, and requires experience in a managed care environment. Commitment to self-development and ongoing training are essential.

Qualifications

• 1-2 years' experience in a managed care environment.
• Training in chronic pain management is a plus.
• Understanding of plan benefit structures and medical terminology.

Responsibilities

• Facilitates department workflow by supporting clinical team.
• Provides non-clinical support to various workflows.
• Coordinates care transitions for hospitalized patients.

Skills

Communication Resources

Community Resource Knowledge

Utilization Management

Case Management

Disease Management

Job description

Shift: 8:00 AM-4:30 PM (could possibly need to fill in for the 11:30 AM-8:00 PM shift as needed)

Description:

JOB SUMMARY:

Facilitates department workflow by supporting clinical team with various care coordination workflows. Locates community services and other referral locations for enrollees, arranges access to care, supports communication with hospitals, and providers.

ESSENTIAL FUNCTIONS:

• Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.
• Trouble shoots when an appropriate provider, type of service, or appropriate level of care cannot be readily found.
• Has current knowledge or researches availability of community resources and services and link members to appropriate services. May assist in transitions in care for hospitalized patients and makes appropriate placements, if needed.
• Assumes responsibility for self-development and career progression. Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role. Assists in the mentoring and training of new Care Workers. Remains responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
• Coordinates and manages distribution of correspondence and materials to enrollees and providers.
• Participates in operational activities, including data collection, tracking, and analysis.

Requirements/Certifications:

REQUIREMENTS:

• 1-2 years’ Experience in a managed care environment, integrated medical and behavioral health care and/or training in chronic pain management.
  
• Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources.

Additional Information

All your information will be kept confidential according to EEO guidelines.