Job Details

Position Purpose:
Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.

Education/Experience:
Requires a High School diploma or GED
Requires 1 - 2 years of related experience

License/Certification:

For Florida-Sunshine Health Plan - All interactions with members aredone telephonically.
For Arkansas Total Care plan - This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required" "Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate

Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed

Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan

Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service

May support performing service assessments/screenings for members and documenting the member's care needs

Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed

Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards

Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager

Provide education on benefits and resources available
Performs other duties as assigned.

Complies with all policies and standards.

EEO:

"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."

Position Purpose:
Supports care management activities by coordinating services for assigned members to ensure timely delivery of care through healthcare providers and community partners. Serves as a key point of contact for members by conducting outreach telephonically and through field-based visits, promoting continuity of care, addressing social determinants of health, and supporting member engagement and satisfaction. Documents care coordination activities and plans in accordance with organizational, state, and regulatory requirements. Travel between multiple counties with approximately 25%-50% travel.

Education/Experience:
Requires a High School diploma required
Requires 1 - 2 years of related experience required
Reliable internet service required

License/Certification: Driver's license

Conducts proactive outreach to members via telephone and in-person visits in homes, shelters, hospitals, and substance use treatment facilities to support engagement in Care Management services.
Identifies member needs related to medical care, behavioral health, and social determinants of health, and connects members to appropriate resources and services.
Provides education to members on available benefits, programs, and community resources.
Collaborates with Care Managers, Disease Managers, and other internal and external partners to facilitate member services and continuity of care.
Identifies changes in member status and makes appropriate referrals to Care Managers, community-based organizations, and other support services.
ccurately documents outreach activities, care coordination actions, and member interactions in designated systems in compliance with state, contractual, and regulatory standards.
dheres to established policies, procedures, standards of practice, and regulatory guidelines.
Performs other duties as assigned and complies with all organizational policies and standards.

Story Behind the Need

• What is the purpose of this team?
• Describe the surrounding team (team culture, work environment, etc.) & key projects.
• Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?

Care Coordinators provide assistance to members through telephonic outreach and field-based visits. The team is located across the state to effectively meet the needs in various areas. Care Coordinators work independently to manage assigned responsibilities while meeting tight timelines and responding efficiently to member needs. Typical Day in the Role

• Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
• What are performance expectations/metrics?
• What makes this role unique?

Telephonic outreaches are assigned daily. Care Coordinators are required to complete a structural outreach cadence consisting of three outreach attempt over three days, made three different times of day with all attempts completed within five business days. During successful calls, CC will assess and identify member needs and provide direct assistance or coordination of services. Ex: If a member does not have a PCP, the CC assists in identifying an in network provider and facilitate appointment scheduling by a three way call. Field visits are assigned on member need and may include outreach to homes, shelter, hospitals, or substance use treatment facilities. Candidate Requirements Education/Certification Required: High School Diplom Preferred: High School Diplom Licensure Required: Drivers License Preferred: Driver's License Years of experience required: 1 to 2 years in social work, nursing, or healthcare related setting with experience supporting individuals through care coordination, case management, or community based services.

Disqualifiers:

dditional qualities to look for: Time management and self-direction, ability to engage members with compassion, and the ability to problem solve.

• Top 3 must-have hard skills stack-ranked by importance

1 Engagement and Communication 2 ligning care with covered benefits, eligibility and community resources 3 bility to navigate multiple computer systems Candidate Review & Selection

• Shortlisting process
• Candidate review & selection
• Interview information
• Onboard process and expectations

Projected Manager Candidate Review Date: 1-2 days post shortlisting resumes to HM
Type of Interviews:
Teams - with video Required Testing or Assessment (by Vendor): No Next Steps

• Do you have any upcoming PTO?

No