Clinical Program Coordinator Medicare

Jefferson Health; Philadelphia, Northern (Philadelphia County, KY); Hybrid; USD 40,000 - 70,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Tuition assistance

Job summary

Jefferson Health in Philadelphia, PA, seeks a non-clinical coordinator to support Medicare clinical programs. You will organize interdisciplinary care team meetings, manage communications (including Right Fax) and maintain regulatory calendars, ensuring timely reporting and contract compliance.

Ideal candidates have a high school diploma, 2+ years in managed care, and proficiency with Microsoft Office. Strong organizational and communication skills are essential for success in this role.

Qualifications

• High School Diploma or GED required.
• Minimum 2 years managed care experience preferred.
• Proficient with Microsoft Office and data tracking.

Responsibilities

• Coordinate and schedule Interdisciplinary Care Team meetings for Medicare and vendors.
• Serve as point person for all Medicare requests and maintain calendar of regulatory deliverables.
• Complete regulatory functions to ensure deadlines and contract compliance.
• Manage outbound member mailings and inventory to support outcomes.
• Maintain tracking of CMS submissions and approval materials.
• Run reports to support managers in assessing productivity.
• Develop Business Requirement documents for IT with clinical teams.
• Provide relief coverage for the Health Care Management vendor coordinator.
• Schedule interviews for candidates and set up HEAT tickets for devices.
• Support clinical programs targeting HEDIS, STARS, and corporate goals.
• Other duties as assigned

Skills

Independent work

Microsoft Office

Communication skills

Organizational skills

Multi-tasking

Regulatory reporting

Education

High School Diploma

Associate degree preferred

Bachelor degree preferred

Tools

Outlook

Word

Excel

Visio

Job description

Job Details

Works with minimal supervision to coordinate and execute various non clincial components of the Health Partners Plans Clinical Programs Medicare.

Job Description

• Coordinate and schedule Interdisciplinary Care Team meetings for Medicare and vendors as well as manage various forms of communication such as Right Fax for all clinical programs.
• Serve as point person for all Medicare requests that pertain to clinical programs and maintain an ongoing calendar of deliverable dates for regulatory reporting.
• Complete regulatory functions under the supervision of the respective Manager to ensure compliance to deadlines and contract requirements.
• Manage all outbound member mailings; maintain inventory and fulfillment process to improve health outcomes for our members.
• Maintain a tracking inventory of materials submitted to CMS for approval.
• Running reports to support managers in assessing productivity.
• Work with the clinical care teams to develop Business Requirement documents for IT.
• Provide relief coverage for the Health Care Management vendor coordinator. May include CCMS notifications.
• Schedule interviews for prospective candidates for the clinical programs and confirm and set up new hire HEAT ticket for computers and phone.
• For all clinical programs that are targeting improvement in HEDIS, Corporate Goals and STARS.
• Other duties as assigned

Education

Required

• High School Diploma/GED

Preferred

• Associate’s Degree Graduate of an accredited school with a minimum of an Associate Degree, Bachelor Degree preferred.

Experience

Preferred

• 2 years Minimum of two years of managed care experience

Knowledge, Skills and Abilities

Required

• Ability to function independently with minimal supervision.
• Able to self-direct
• Proficiency with Microsoft Office Suite (Outlook, Word, Excel, Visio)
• Basic relational database experience
• Analytic and problem solving skills
• Strong organizational skills
• Able to manage multiple priorities and meet deliverables
• Excellent verbal, written communication and presentation skills
• Ability to provide guidance to the Clinical team as needed

Preferred

• Project coordination experiences a plus.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular Employee

Entity

Jefferson Health

Primary Location Address

Northeast Primary Location Address 901 Market Street, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.

Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance. For more benefits information, please

In keeping with Jefferson's Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. If you are enthusiastic, caring and dedicated to service excellence, we invite you to consider joining Jefferson.

Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education.

With a long standing history, Jefferson has been advancing the medical field from the heart of Center City Philadelphia for nearly 200 years.

Our Mission, We Improve Lives, expands to every corner of the organization. From our weekly farmer’s market, to our new Jefferson Accelerator Zone for innovation, our employees’ passion for the community is evident by the daily gestures towards our patients, students and each other.