Clinical Care Coordinator

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

📋 Description

• Ensure timely scheduling and appointments for members.

• Assist in the implementation and facilitation of services for members.

• Guarantee prompt follow-up with members.

• Effectively interact and communicate with members during phone interactions.

• Motivate member engagement and adherence to the program.

• Provide assistance for all calls made to members.

• Coordinate the delivery of high-quality, cost-efficient care according to members' needs and the managed long-term support and services model, adhering to clinical practice guidelines established by the plan.

• Generate reports to track compliance with scheduled services, ensuring timely delivery and necessary follow-up.

• Employ care management processes for goal-oriented member care.

• Document information accurately and thoroughly in accordance with established practice standards and current organizational policies.

• Offer telephonic support for activities relevant to the program.

⛳️ Requirements

• High School Diploma or GED is mandatory.

• Experience in the healthcare sector is preferred.

• A minimum of one (1) year of experience in home care, discharge planning, or case management is necessary.

• Experience with the elderly frail population is desirable.

• At least one (1) year of experience in the managed care sector is preferable.

• Comprehensive knowledge of service coordination standards and service delivery is required.

• Strong understanding of managed care principles and concepts, including Health Plan Effectiveness Data and Information Set (HEDIS), is essential.

• Excellent organizational skills are required.

• Proficient PC skills, familiarity with Medical Management systems for electronic medical records, and the capability to use Microsoft Office applications (Excel, Access, Word, etc.) are necessary.

• Strong problem-solving and conflict resolution abilities are required.

• Good presentation skills are necessary.

• Ability to work with minimal daily supervision is required.

🏝️ Benefits

• Comprehensive health benefits including Medical, Dental, and Vision coverage.

• Retirement plans are available.

• Generous Paid Time Off (PTO) is offered.

• Incentive plans are in place.

• Wellness programs are provided.

• Paid Volunteer Time Off is included.

• Tuition reimbursement is available.