Intake Coordinator, Case Management

** Workforce Classification:
** Telecommuter
* * Join Our Team:
Do Meaningful Work and Improve People’s Lives
** Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for.

Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog:  .
** This is a work from home opportunity!
**** Experience in Motivational Interviewing is highly preferred!
** The
** Intake Coordinator
** is responsible to provide the initial outreach, engagement, and screening of members. The intake coordinators educate and assists members in accessing care to close care gaps, utilizing digital resources to support condition self-management, and engage members in case management services. Our intake coordinators support our case management program through specialized assistance including assisting members in accessing centers of excellence (COE) and support the COEs by gathering the member medical records for providers to make determinations, researching complex clinical information, identifying community resources to meet unique member social determinants of health needs, and locating in-network providers (e.g., primary care, specialty, and behavioral health).Services

include answering and managing member, provider and warm transfers to our phone queue, and researching, gathering and analyzing data, writing reports/presentations and presenting findings on a variety of projects that support Clinical Programs.

** What you'll do:
*** Provides initial screening of potential complex case management referrals, including screening warm transfers from Customer Service and vendor referrals (e.g., Nurse Line, EAP).
* Works with Case Managers to ensure potential case management referrals are appropriate for the program.
* Researches and provides clinical and complex resource information for case managers and engagement specialists to assist in the management of complex case management cases including maintaining community resource knowledge base.
* Applies nationally accepted criteria to pre-screening members.
* Educates potential candidates for case management regarding the overall case management programs and obtains permission for services, if appropriate.
* Identifies and works to resolve social determinants of health issues that impede proper use of health care services or access to services.
* Informs members of designated programs, gather medical records on behalf of the member and COE
* Research complex clinical information, community resources and locates providers with openings (e.g., residential treatment centers, specialists)
* Ensures documentation is clear, concise and meets all regulatory, legal and accreditation standards.
* Answers calls from members, providers and warm transfers (e.g., Nurse Line, Customer Service) to assist members in accessing care.
* Answers digital member inquiries in our mobile app.
* Triages members (e.g., calls, digital)
* Researches, gathers, and analyzes data; writes reports, including departmental reports such as but not limited operational (e.g., referral source, volume, case assignment), outcome (e.g., satisfaction, clinical), NCQA and quality improvement projects.
* Works collaboratively with providers and support embedded / designated case managers ensuring provider specific reporting (e.g. inpatient notifications, member data, etc.) is provided in a timely manner and ensure accuracy of information shared.
* Identifies emergency department, urgent case and pharmacy utilization concerns and acts to resolve them by working with members, providers, Premera staff and community liaisons as indicated.
* Acts as point person to assist with case management…