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Care Coordinator

Company: Blue Cross of Idaho
Location: Meridian
Posted on: May 11, 2019

Job Description:

Position Description

Under limited supervision, effectively case-manage members utilizing a collaborative process. Assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs using communication and available resources to promote quality, cost-effective outcomes. Work closely to coordinate care with providers, primary care teams, and social services agencies to provide ongoing care coordination, connection to resources, and support to plan members while improving their health and general well-being through education and provision of coordination of care and services. Support providers and Care Coordination staff through an integrated approach to case management and community outreach.

--- Responsible for establishing trusting relationships, while exhibiting excellent working relations, with members, families, providers, and BCI staff.

--- Communicate to members the purpose of the CHW and the impact it may have on their well-being. Help members identify socio-economic issues that affect their overall health and develop health/social management plans and goals.

--- Provide ongoing follow-up, basic motivational interviewing, and goal setting with members/families.

--- Conduct in person assessments with members, including coordinating care with other providers, and/or community resources and other programs. Motivate members to be active and engaged participants in their health and overall well-being.

--- Follow-up with members via phone calls and on-site visits.

--- Facilitate coordination for members in accessing appropriate health related services, community agencies, and providers.

--- Identify opportunities for intervention.

--- Work closely with medical provider to help ensure that members have comprehensive and coordinated care. Follow-up with members should be continuous from initial identification through closure. Coordinate and monitor services, including comprehensive tracking of members compliance in relation to care plan objectives.

--- Help members review benefit concerns and connect with appropriate BCI internal resources to expedite resolution of concerns and inquiries.

--- Work collaboratively with other BCI clinical personnel assigned to the same member. Responsible for providing consistent communication to other Care Coordination staff to evaluate member/family status, ensuring that provided information, and reports clearly describe progress.

--- Provide support and advocacy during medical care or when necessary to assure members medical needs and referrals required are being conveyed. Identify and assist with care coordination related to Gaps in care.

--- Document all member encounters and contacts made on behalf of members. Complete and submit monthly reports; maintain comprehensive electronic member files, which include member notes, release of information, assessments and other medical documents acquired on behalf of the member. Document activities, service plans, and outcomes achieved by member in an effective manner.

--- Attend regular staff meetings, trainings, and other meetings as requested.

--- Travels to on-site locations, various agencies, and other outreach destinations.

--- Act as a resource for internal and external customers

Position Requirements

Required Experience:

--- 3 years' experience within health insurance, health care, health-related industry

--- Experience with navigating local community resources

Required Education:

--- Associate's degree, preferably in Health Science, Public Health, Community & Environmental Health, or
other healthcare related field.

--- Preferred degree as Social Worker or LPN or other clinical designation involved in care coordinating

Knowledge of:

--- Community agencies and resources

--- Multi-system outreach programs related to health care delivery, clinical education, and health-related

--- Managed care delivery systems

--- Quality Improvement (QI)

--- Center for Medicare and Medicaid Services (CMS)

--- Long Term Services & Supports (LTSS)

--- Unique aspects of providing services to a Medicaid population

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Keywords: Blue Cross of Idaho, Meridian , Care Coordinator, Other , Meridian, Idaho

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