Medical Care Coordinator Maternal Health

Corewell Health; Grand Rapids (MI); Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare organization in Michigan is seeking a Medical Care Coordinator to support prenatal and postpartum members. In this virtual role, you will engage with members to assess their care needs and navigate them through complex health resources. Ideal candidates should possess an Associate's Degree in a health care focus and experience in maternal health. This position offers a comprehensive benefits package and contributes to improving outcomes for Medicaid members.

Benefits

Comprehensive benefits package

On-demand pay

Discounts

Optional identity theft protection

Qualifications

• Associate's Degree or LPN/Social work with relevant experience.
• Skills gained through clinical office or health insurance experience.
• Preferred 5 years in a clinical office or health insurance setting.
• 3 years in a managed care organization.

Responsibilities

• Navigate members through health systems and options.
• Assess member needs and provide care management.
• Guide members through internal and external resources.
• Act proactively on behalf of members with care gaps.
• Manage a caseload of 150-300 members.

Skills

Experience in Maternal Health

Understand complex health care systems

Navigational skills for members

Proactive patient engagement

Education

Associate's Degree with a health care focus

Job description

Medical Care Coordinator Maternal Health

Priority Health's Medicaid Care Management Team is seeking a compassionate and dedicated Medical Care Coordinator with a strong passion for supporting individuals during the prenatal and postpartum periods. In this virtual role, the coordinator will proactively engage with pregnant and postpartum members to assess and support their care needs, ensuring timely access to resources and services. Ideal candidates will have experience working with maternal health populations and a commitment to improving outcomes for Medicaid members.

The coordinator will be responsible for the following essential functions:

• Telephonically navigate members through our complex systems by working across the health plan and care network to ensure members receive and understand their care options.
• Assess and identify the needs of members and evaluate to determine if the member needs complex care management. If the needs are not complex, assist the member to meet their health care needs.
• Guide members through Priority Health networks, internal and external medical resources, policies, procedures, etc.
• Act proactively on member's behalf with routine benefits, gaps in care, and prior authorization processes.
• Work directly with members with rising risk or identified with rising risk under supervision of a licensed Care Manager to provide delegated tasks for disease-specific education for both adult and pediatric population, and reinforcement of the treatment plan.
• Identify barriers and social determinants of health and assist to address or eliminate these barriers.
• Manage a caseload of approximately 150-300 members with stable but complex conditions or rising risk related to chronic conditions.

Qualifications include:

• Associate's Degree with a health care focus or LPN or Social work, preferably with 2 years of experience in Maternal Health.
• Skills/knowledge/abilities typically gained through less than 2 years of related work experience in a clinical office or health insurance setting.
• 5 years of relevant experience in a clinical office or health insurance setting (preferred).
• 3 years of relevant experience working in an organization of size and complexity comparable to Spectrum Health or managed care organization.

Corewell Health offers a comprehensive benefits package, including on-demand pay, discounts, and optional identity theft protection. We are committed to providing a safe environment for our team members, patients, visitors, and community, and we require a drug-free workplace.

Corewell Health is an equal opportunity employer and invites those who share in our commitment to diversity, equity, and inclusion to join our team.