Care Coordinator III

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Assist in Long Term Care Care Coordination through outreach to members, managing mailings, scheduling appointments, and sending reminders, as well as coordinating prescriptions and following up with providers.

• Collaborate with the senior care management team and designated member teams to guarantee provider services, ensure continuity of care, and enhance member satisfaction.

• Engage in member outreach via phone or home visits to review care plans, address resources, and respond to questions, concerns, and ongoing educational needs.

• Coordinate care activities alongside healthcare and community providers, partners, members, and caregivers.

• Address inquiries, requests, and concerns from members and providers regarding care plans.

• Communicate effectively with care managers, practitioners, and additional stakeholders to streamline member services.

• Conduct service assessments and screenings while documenting member care requirements.

• Maintain accurate member records and distribute necessary documentation to providers.

• Triage, modify, and escalate complex requests to management when necessary.

• Identify member needs and make referrals to Care Managers, community-based organizations, and Disease Managers.

• Provide educational support regarding available benefits and resources.

• Assist in identifying training and development needs.

• Adhere to policies, contractual obligations, regulatory guidelines, and standards.

• Undertake additional duties as assigned.

⛳️ Requirements

• Must be a resident of Ohio.

• High School diploma or GED required.

• 2 - 4 years of relevant experience is necessary.

• Preference will be given to candidates with experience in managed care, physician office or health system operations, healthcare administration, and/or medical terminology.

• Must be available to work from 8am to 5pm ET, with potential for overtime including evenings and weekends.

• Ability to travel up to 10% to various Ohio offices for essential business meetings.

• Knowledge of care management services and experience managing complex or escalated issues.

• Capability to perform service assessments/screening for members with intricate needs.

• Proficiency in documenting member records in compliance with state and regulatory requirements.

• Familiarity with contractual obligations and regulatory guidelines and standards.

🏝️ Benefits

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off.

• Holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Potential for overtime, including evenings and weekends as necessary.