Clinical Care Coordinator

The Clinical Care Coordinator is responsible for welcoming and onboarding new members to the health plan, completing and scheduling assessments and works collaboratively with the health care team to manage and coordinate care for members. This role is also responsible for locating and reengaging those who are difficult/unable to reach through office and community-based efforts. Community-based efforts include, but are not limited to: member home visits, provider office visits, hospitals and other areas.

The Clinical Care Coordinator must work collaboratively with members, caregivers, member relatives and health care providers to ensure quality and cost-effective patient-centered care. The Clinical Care Coordinator should feel comfortable when working to overcome environmental, cultural and language barriers. This position works directly with members, staff, managers, and both internal/external customers.

Duties and Responsibilities Responsibilities include, but are not limited to, the following:

Under the direction of the Manager within Clinical Operations, the Clinical Care Coordinator performs ongoing care coordination activities including:

Conducts outreach telephonically, virtually, and/or face to face Completes Health Risk Assessment (HRA), initial health screening and member welcome calls

Provides telephonic initial screen of non-medical needs, coordinates services with clinical team and makes appropriate referrals

Provides information to members/clients and/or their care teams regarding social and community supports

Provides assistance with calls to various social service agencies, as appropriate

Performs off-site visits (such as, but not limited to: home, hospital, community health centers or other community agencies) as necessary or required

Provides assistance and collaborates with clinical teams in obtaining access to care, DME and services

Directs members/clients to internal departments within Neighborhood as appropriate

Provides comprehensive documentation of all activities and contacts in appropriate software system

Manage a caseload of assigned members

Collaborates with clinical team and schedules visits for licensed staff

Provides cross-coverage as assigned by Manager Participates in Outreach/Marketing activities as needed and appropriate

Maintains up-to-date knowledge of resources in Rhode Island Performs other duties as assigned in alignment with care coordination responsibilities

Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood’s Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Qualifications

Required:

Associates Degree in human service related field or equivalent years of background and relevant work experience to equal the degree

Minimum of one (1) or more years working in community outreach or within a community-based organization setting with individuals having social, behavioral and/or long-term care needs

Three (3)+ years’ experience in medical or social services setting or minimum of six (6) months experience working in a position within Neighborhood Health Plan of Rhode Island Knowledge of community social service resources, State agencies and the state Medicaid program

Ability to conduct telephonic, virtual and in-person assessments with clear communication

Strong oral and written communication skills

Strong customer service orientation

Strong interpersonal skills

Strong organizational skills

Ability to problem solve and work independently with minimal supervision

Strong collaborative skills and teamwork values

Computer literacy with windows-based programs

Sound judgment and strong time management skills

Ability to keep accurate records and documentation using electronic medical record/care management system

Flexible schedule including evenings and weekends

Ability to travel for work, must have access to reliable transportation and/or valid driver’s license and proof of insurance if using personal vehicle

Preferred:

Clinical specialty experience

Knowledge of medical terminology

Knowledge/expertise in substance use and/or mental health

Bilingual

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
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