Member Care Coordinator

Community Care of North Carolina Inc; North Carolina; Híbrido; USD 36.000 - 48.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Bonus incentives

Growth opportunities

Training opportunities

Descripción de la vacante

Community Care of North Carolina Inc. is seeking a Member Care Coordinator to support the care management team, close care gaps, and reduce hospital utilization across North Carolina.

The role may be remote within regions or on-site at CCPN practices, contributing to a multi-disciplinary approach and adherence to privacy policies. The position requires health care experience, strong data system skills, and the ability to coordinate referrals and care across diverse providers.

Formación

• High school diploma or GED required.
• 2-4 years minimum experience in a health care setting required.
• 2 or 4-year degree in health-related field preferred.
• Bilingual preferred.

Responsabilidades

• Receive and document all referrals from various sources into the care management documentation platform.
• Outreach, Engagement, and scheduling of members for Care Managers.
• Assist with mailing educational materials, consent forms or other documents to the member as necessary.
• Assist with referrals on behalf of the Care Management or program team.
• Assist with tasks delegated by the Care Management or program team.
• Assist member with care coordination and health care system navigation.
• Identify care gaps and outreach to members to close gaps as requested.
• Assist practice to submit supplemental data to health plans to provide documentation of gap closure as requested; assist with scheduling medical appointments and transportation as needed.
• Assist with pulling Care Gap/Recommended Actions/High Risk reports.
• Access multiple EHRs (electronic health records) to obtain and upload documents into the care management platform.
• Access to Hospital/Data or Electronic Medical Record system will be required, as necessary.
• Collaborate with the Care Team to address barriers and create efficiency with processes.
• Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded.
• Abide by department guidelines, company policies, and HIPAA regulations.
• Attend Departmental and corporate meetings, local and regional trainings, or other events as required.
• Travel may be required within the region and/or the State.
• Make a meaningful impact on youth and families across North Carolina
• Work with a supportive and collaborative care team
• Opportunities for growth, training, and bonus incentives*

Conocimientos

Healthcare experience

Data systems

MS Office

Organization & time management

Cultural sensitivity

Medical terminology

Adaptability

Communication with multiple contacts

Equipment & technology use

Educación

High school diploma or GED

2-4 year degree in health-related field

Bilingual preferred

Herramientas

EHR systems

MS Office

Descripción del empleo

About CCNC From the mountains to the coast, from large cities to small towns, Community Care of North Carolina is transforming health care. Informed by statewide data and predictive analytics, community-based care-managers work with local physicians and diverse teams of health professionals to develop whole-person plans of care that connect people to the right local resources and increase equity and access to high quality care.

To improve the health and quality of life for all North Carolinians by building supporting better community-based healthcare delivery systems.

The Member Care Coordinator position is a non-clinician role that works in collaboration with the Care Management staff and/or quality improvement staff to support the multi-disciplinary team approach of patient care by meeting key performance indicators (closing care gaps, reducing hospitalizations, readmissions, ED (Emergency Department) utilization, and PMPM costs) and other organizational mandates as designated. The Member Care Coordinator may work remotely within regions to cover the needs across the state and/or may work on site at CCPN (Community Care Physician Network) practices.

Member Care Coordinators may directly assist members by increasing their ability to improve their health outcomes. They also help design and implement systems to ensure the smooth operation of office functions and to support the Care Team.

Member Care Coordinators may also work directly with assigned practices to assist them in addressing care gap closure in collaboration with the Provider Relations Representative/QI Team.

• Receive and document all referrals from various sources into the Care Management documentation platform.
• Outreach, Engagement, and scheduling of members for Care Managers.
• Assist with mailing educational materials, consent forms or other documents to the member as necessary.
• Assist with referrals on behalf of the Care Management or program team.
• Assist with tasks delegated by the Care Management or program team.
• Assist member with care coordination and health care system navigation.
• Identify care gaps and outreach to members to close gaps as requested.
• Assist practice to submit supplemental data to health plans to provide documentation of gap closure as requested; assist with scheduling medical appointments and transportation as needed.
• Assist with pulling Care Gap/Recommended Actions/High Risk reports.
• Access multiple EHRs (electronic health records) to obtain and upload documents into the care management platform.
• Access to Hospital/Data or Electronic Medical Record system will be required, as necessary.
• Collaborate with the Care Team to address barriers and create efficiency with processes.
• Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded.
• Abide by department guidelines, company policies, and HIPAA regulations.
• Attend Departmental and corporate meetings, local and regional trainings, or other events as required.

• High school diploma or GED required
• 2-4 years minimum experience in a health care setting required
• 2 or 4-year degree in health-related field preferred
• Bilingual preferred

• Knowledge of and experience working in patient or clinical data systems
• Computer skills required including various office software and the internet; experience with MS Office software preferred
• Organizational and time management skills
• Sensitivity to diversity of cultures, language barriers, health literacy and educational levels
• Knowledge of medical terminology
• Able to shift strategy or approach in response to the demands of a situation
• Multiple contacts are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office, community, and household conditions, as well as communicable disease could occur.
• Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices

Travel may be required within the region and/or the State.

Make a meaningful impact on youth and families across North Carolina

Work with a supportive and collaborative care team

Opportunities for growth, training, and bonus incentives*

Ready to improve the health and quality of life of all North Carolinians by building and supporting better community-based health care delivery systems?