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CM Coordinator - Full Time, Days
Prospect Medical Holdings - Johnston, RI
posted 2 months ago
About the position
The Case Management Coordinator is responsible for managing and coordinating care for high-risk members, assisting care managers in developing comprehensive care plans, and facilitating member outreach. This role involves tracking member adherence to care plans, participating in patient education, and coordinating services with interdisciplinary care team members. The coordinator also maintains documentation, manages referrals, and ensures compliance with department standards while providing excellent customer service.
Responsibilities
- Manage and coordinate care for high-risk members.
- Assist care managers in developing comprehensive care plans and identifying barriers for members.
- Perform member outreach, including post-discharge calls, to facilitate appointments and symptom tracking.
- Facilitate referrals to interdisciplinary care team members to address barriers.
- Track member adherence with care plans.
- Participate in patient education regarding urgent care, hospice, and chronic care management.
- Manage a panel of non-complex members and maintain a task file for follow-up calls.
- Notify aligned case manager when members are due for re-assessment.
- Assist case manager in arranging services for members, such as DME and transportation.
- Process referral requests for interdisciplinary team members.
- Assist with maintaining and preparing charts for audits.
- Document all pertinent information and prepare discharge summaries for the Case Management Team.
- Use applicable computer and office systems to coordinate documentation and data.
- Establish and maintain effective filing systems and complete assigned clerical functions.
- Cover ACD phone line as per department policies.
- Ensure the work area is clean and organized.
- Demonstrate appropriate use of independent judgment and decision-making.
- Adhere to all department policies and procedures, including confidentiality and HIPAA regulations.
- Back up UM Coordinator as needed and complete ad hoc projects in a timely manner.
Requirements
- High School Diploma or Equivalent.
- One year of related office, business, or administrative experience.
- Strong knowledge of Medical Terminology.
- Excellent customer service skills and telephone etiquette.
- Ability to read, write, and communicate effectively in English.
- Computer literacy and proficiency in MS Office Suite.
- Ability to type 60 words per minute.
- Ability to establish and maintain effective working relationships at all levels of the organization.
- Ability to communicate clearly and concisely.
- Ability to multitask and prioritize needs to meet timelines.
- Ability to maintain a work pace appropriate to the workload.
Nice-to-haves
- Certified Nursing Assistant (CNA).
- Certified Medical Assistant (CMA).
- Healthcare or Managed Care experience.
- Ability to read, write, or speak Spanish and Portuguese.
Benefits
- Competitive pay rate of $25 - $32 per hour.
- Opportunities for professional development and training.
