Location Address:


Compensation Pay Range:
Minimum Offer $31.50Maximum Offer $53.66

Summary:
Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the
continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member s legal representative, physician, care providers, and
ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care
services. Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and
evaluation for cost effective and quality outcomes

Type of Opportunity: Full timeFTE: 1.00Job Exempt: NoWork Shift: Weekday Schedule Monday-Friday (United States of America)

Responsibilities:
*Supports Health plan members
*Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the
continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member s legal representative, physician, care providers, and
ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care
services.
*Provides care coordination to members with chronic condition with less complex needs including less community resources. Conducts in depth health risk assessment and/or
comprehensive needs assessment which include but not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters. Develops and
communicates plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to home care, back up
plans, community based services).
*Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; collects clinical path variance data that indicates
potential areas for improvement of case and services provided; works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.
*Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which
provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for member s care needs by identifying and
addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members
care plan.
*Provides assistance to members with questions and concerns regarding care, providers or delivery system.
*Conducts face to face home visits, as required.
*Educates providers, support staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates
a team approach to the coordination and cost effective delivery to quality care and services.
*Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.
*Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Generates reports in accordance with care
coordination goals.
*Complies with Case Management Society of America Standards for Case Management Practice and with CCMC code of Professional Conduct for Case Managers.
*Participates in Interdisciplinary Care Team (ICPT) meetings.
*Assists with orientation and mentoring of new team members as appropriate.
CARE COORDINATOR III-11466
*Performs other functions as required.

Qualifications:

Masters Degree & 2 years exp, Bachelors degree & 4 years exp, Associates degree & 5 years exp, 10 years of exp may be utilized in lieu of other education & exp reqs.

Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

Learn more about our employee benefits.