CMS Care Coordinator

$79,040 - $79,040/Yr

Clayton County Board Of Health - Jonesboro, GA

Part-time - Entry Level

Jonesboro, GA

Administration of Human Resource Programs

About the position

The CMS Care Coordinator position is a part-time role that involves providing nursing care and coordination for clients within the Clayton County Health District. Under general supervision, the Care Coordinator will assess client health problems and needs, develop and implement nursing care plans, and maintain accurate medical records. The role requires the administration of nursing care to clients who may be ill, injured, convalescent, or disabled. Additionally, the Care Coordinator may advise clients on health maintenance and disease prevention, as well as provide case management services. This position is crucial in ensuring that clients receive the necessary support and resources to manage their health effectively. The Care Coordinator will be responsible for scheduling enrollment visits, annual visits, and 6-month updates as required by programmatic policies and requested by families and clients. This includes traveling to complete CMS home visits within the Clayton County Health District. Documentation is a key aspect of this role, as the Care Coordinator must document all encounters with families and clients in the M&M system, including communications with internal and external vendors, providers, and community partners. In addition to care coordination, the Care Coordinator will act as a liaison between families and providers/vendors, assisting in the transition of families from pediatric to adult care according to CMS policy. Compliance with HIPAA policies is mandatory, and the Care Coordinator will also be responsible for completing and documenting prior authorizations as requested by families and approved by CMS policy. The role may involve scanning, reviewing, and entering patient information provided by medical providers, as well as updating client files in the M&M system. The Care Coordinator will also be expected to research and provide resources as needed or requested by families, attend meetings, health fairs, conferences, workshops, and other outreach events as necessary. Maintaining nursing licensure requirements, including acquiring continuing education units (CEUs), is essential. In times of public health emergencies, the Care Coordinator may be called upon to provide administrative and/or clinical services in authorized shelters and will also be responsible for billing Medicaid for assessment visits.

Responsibilities

• Schedule enrollment visits, annual visits, and 6-month updates as required by programmatic policies & requested by families & clients.
• Travel to complete CMS home visits within the Clayton County Health District.
• Document ALL encounters with families and clients in M&M, including communications with internal and external vendors, providers, community partners, etc.
• Provide care coordination as stated by programmatic policies, acting as a liaison between families and providers/vendors, and transitioning families from pediatric to adult care according to CMS policy.
• Comply with all HIPAA policies provided by the Department of Public Health via the CCHD intranet.
• Complete and document prior authorizations as requested by families and approved by CMS policy.
• Scan, review, and enter patient information provided by medical providers; update client file in M&M.
• Contact providers to assist with understanding of medical diagnoses, obtaining Rx instructions, prior authorizations, and any other pertinent information necessary to maintain the patient's continuity of care.
• Research & provide resources as needed and/or requested by families.
• Transition clients from a Pediatric to an Adult Model of care.
• Attend meetings, health fairs, conferences, workshops, and other outreach events as needed and/or requested.
• Maintain nursing licensure requirements including acquiring CEUs.
• Provide admin and/or clinical services in authorized shelters as requested by Emergency Preparedness during a public health state of emergency.
• Bill Medicaid for Assessment visits.

Requirements

• Bachelor's degree in Nursing from an accredited college or university OR Associate's degree in Nursing from an accredited college AND Current Georgia License as a Registered Professional Nurse.
• Any related professional work experience.