Compliance Coordinator - Home Care jobs in Hialeah, FL

Description

Location: Corporate- Hybrid   

Classification: Full-time, Exempt

Department: Clinical Operations

Reports to: Department Administrator  

Position Category: Non-Managerial

Last Revised: 1/16/24

At ClareMedica, exceptional is the standard.

Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives.

That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At ClareMedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.

Opportunity awaits – welcome to ClareMedica.

ESSENTIAL FUNCTIONS

The Care at Home Program Coordinator is responsible for supporting the Care at Home Program and is directly responsible for scheduling visits and communicating with primary care providers, patients, and internal stakeholders to maintain proper care coordination and continuity of care. The role also assists with the day-to-day management of the Care at Home Program. 

DUTIES AND RESPONSIBILITIES

• Inbound and outbound calls to schedule, verify, and follow up with Care at Home patients.
• Oversight and Management of Care at Home Program patient schedule.
• Manage inbound and outbound telephone communication in a professional manner and according to productivity and quality standards for Care at Home patients. 
• Process inbound and outbound data and communication (i.e., faxes, emails, and electronic communication) according to productivity and quality standards.
• Enter, review, and or verify member information when confirming or scheduling appointments in the EMR and communicate approved pertinent information with healthcare providers and internal stakeholders as needed. 
• Complete administrative documentation for member records including but not limited to disenrollment, referral, or refill needs, attaching documents (i.e., medical records)
• Assist in smooth coordination of patient care between providers and patients including following up with internal stakeholders to ensure the provider is prepared for home visits. 
• Establish relationships and communicate, when appropriate, with providers, patients, and internal stakeholders. 
• Triage inbound calls manage member inquiries/requests and resolve or escalate to appropriate CHP internal stakeholders as needed. 
• Run and/or review reports to monitor assigned team duties are completed.
• Adhere to organizational, departmental, compliance, and regulatory policies and procedures.
• Promote a positive attitude and work environment.
• Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

This position does not have supervisory responsibilities.

Requirements

QUALIFICATIONS/REQUIREMENTS

• High School Diploma/GED
• Bilingual in English/Spanish-- Must read, write, and speak fluent English.
• At least 2 years’ experience in patient care.
• Able to communicate effectively with empathy over the phone and while interacting with others.
• Good time management skills.
• Excellent analytical and problem-solving skills.
• Excellent verbal and interpersonal skills.

WORKING CONDITIONS

• General office working conditions. 
• Hybrid/Remote Role, Corporate (Miami Lakes is the main office)

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.  

While performing the duties of this job, the employee will be required to stand, walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust to focus. Manual dexterity is required to use desktop computers and peripherals.  

WORK ENVIRONMENT

Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.  

The noise level in the work environment is usually moderate.

TRAVEL

Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.

SAFETY HAZARD OF THE JOB

Minimal Hazards

This job description does not list all duties and responsibilities of the job. You may be asked by supervisors or managers to perform other instruction, duties and responsibilities, as appropriate. You will be evaluated in part based upon your performance of the duties and responsibilities identified in this job description. 

Management has the right to revise this job description at any time. The job description is not a contract for employment, an either you or the employer may terminate employment any time, with or without cause.