Care Coordinator, BH

• Competitive salaries

It’s an exciting time to join the Well Sense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

The Care Coordinator is a member of the Care Management team responsible for engaging members through telephonic or face-to-face outreach, assessing non-clinical and social needs, and coordinating access to healthcare, behavioral health, and community-based services. The Care Coordinator serves as a key resource for members, providers, and internal stakeholders by facilitating care coordination, addressing barriers to care, connecting members to resources, and supporting positive health outcomes.

Using motivational interviewing and member-centered engagement strategies, the Care Coordinator supports members across multiple care management programs and populations, including complex care management, transitional care, maternal health, population health, and behavioral health initiatives. The Care Coordinator collaborates closely with clinical staff, customer care teams, providers, community organizations, state agencies, and contracted vendors to ensure members receive appropriate services and support.

• Full-time remote work
• Competitive salaries
• Excellent benefits

• Supports programs and clinical best practices with the objective of improving health outcomes, preventing hospital readmissions, improving member safety and reducing medical errors, and promoting health and wellness activities, where appropriate.

• Conduct outreach, screenings, assessments, and interviews to identify member needs and engage members in care management programs.
• Utilize motivational interviewing techniques to enhance member engagement and participation in healthcare and care management activities.
• Educate members regarding benefits, healthcare services, community resources, preventive care, and condition-specific health information.
• Provide appointment reminders, wellness visit support, and preventive care outreach activities.
• Complete member satisfaction and case closure activities as assigned.

• Coordinate access to medical, behavioral health, substance use disorder, and community-based services.
• Facilitate referrals and connections to providers, vendors, community organizations, and state agencies.
• Advocate on behalf of members to reduce barriers to care and address social determinants of health, including housing, transportation, food insecurity, education, legal services, and other community support needs.
• Support member access to medications, medical equipment, healthcare appointments, and other services that promote treatment adherence and improved health outcomes.
• Collaborate with providers, facilities, community agencies, and interdisciplinary team members to ensure coordinated care and successful transitions between care settings.
• Maintain current knowledge of community resources and available support services.

• Triage cases, referrals, and member needs to clinical staff, providers, vendors, and internal departments as appropriate.
• Answer and triage calls from departmental phone lines and shared mailboxes.
• Support care management programs through outreach, follow-up activities, and operational workflows.
• Partner with leadership and team members to prioritize work, manage assignments, and support departmental goals.
• Participate in team meetings, quality improvement initiatives, and workflow enhancement activities.
• Identify opportunities to improve efficiency, member experience, and departmental processes.

• Maintain accurate, timely, and complete documentation in care management and medical management systems in accordance with regulatory, contractual, accreditation, and organizational requirements.
• Prepare reports, monitor assigned metrics, and support departmental data collection activities.
• Provide administrative support for meetings, projects, audits, and care management initiatives.
• Perform other duties as assigned.

• Associate degree in Healthcare, Human Services, Social Work, Psychology, Public Health, or a related field required; or equivalent combination of education and relevant experience.
• Bachelor's degree in a related field preferred.

• Two (2) years of experience in healthcare administration, care…