Managed Care Coordinator jobs in Monroe, LA

POSITION DESCRIPTION:

Responsible for the overall coordination of care for patients. Care Coordinators work with affiliated agencies, such as counselors or other medical facilities, and act as advocates between patients and other medical facilities; helps to ensure patients understand every aspect of their care while also working and making decisions that are in the best interest of the patients. This position requires compliance with CHS written standards, including the Compliance Plan and policies and procedures (including the Code of Conduct), as well as assistance in the continuous monitoring, reporting and corrective action processes of corporate compliance.

Essential Duties and Responsibilities:

Every effort has been made to make your job description as complete as possible. However, it in no way states or implies these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude these from the position if the work is similar, related, or is a logical assignment to the position.

1. Counsels’ patients upon first visit to the clinic, with a face-to-face encounter, regarding all available services at CommuniHealth Services (CHS) and documents actions appropriately according to policy and procedures.

2. Maintains knowledge of Workman’s Compensation procedure.

3. Acts as patient advocate, identifies and develops new community resources and assists with problem solving and documents actions in a patient case.

4. Works with patients to identify government programs such as Medicaid, WIC, welfare, food stamps, social security disability or unemployment eligibility and documents in a patient case.

5. Completes annual training as a certified application counselor.

6. Assists patients with completion of online applications for health insurance and Medicaid.

7. Acts as patient advocate to link patients with drug manufacturers’ indigent care programs such as 340-B program, follows-up on pending prescription assistance applications to ensure patients receive medications timely, and works with patients to timely file renewal applications and refill medication orders.

8. Collaborates with fellow Care Coordinators and coworkers in a teamwork environment.

9. Maintains knowledge of and access to Azara DRVS.

10. Downloads Pre-visit planning report from Azara, reviews patient charts for accuracy of included information and addition of missing information. Makes notes as appropriate and distributes copies to each team member while hosting the morning huddle at the beginning of each shift.

11. Maintains an electronic copy of each PVP report, with notes, for a minimum of one year.

12. Maintains knowledge of the Patient Access job description and fulfills roles as outlined while working as a Patient Access Clerk.

13. Maintains compliance with and knowledge of all CHS departmental, facility specific and system-wide policy and procedures.

14. Completes required CHS training per policy, maintains compliance with and knowledge of all CHS departmental, facility specific and system-wide policy and procedure, attends mandatory departmental meetings and/or training, and follows CHS Mission, Vision and Values in delivery of all services.

15. Maintains strictest confidentiality and adheres to all HIPAA guidelines/regulations as well as compliance with HRSA regulations.

16. In addition to the outlined duties above, as a patient-centered medical home, the incumbent fulfills the principles and theories outlined in organizational policies including assisting navigating patients as needed through the health system making appropriate referrals to case/care management, communicating with the healthcare team to address patient / family caregiver specific needs, etc.

17. Performs all other duties as assigned.

Education:

1. High School diploma or GED

2. Maintains annual certification as ACA counselor and CAC Medicaid

Skills/Experience:

1. Must be able to read, write, and speak the English language in an understandable manner.

2. Preferred one (1) year of medical clinic experience.

3. Ability to establish and maintain effective working relationship with patients, employees and the public.

4. Ability to perform well-organized and detail-oriented work while maintaining privacy in all aspects of the job.

5. Competence to gather information such as vital signs, weight, changes in medical history including medications, and utilize screenings and interpret results of those screenings during each telehealth appointment.

Environmental/Working Conditions:

1. Works in a well-lighted/ventilated office area of the facility.

2. Is subject to frequent interruptions.

3. Is involved with personnel, patients, visitors, government agencies/personnel, etc., under all conditions/circumstances.

4. Is subject to hostile and emotionally upset personnel, patients, visitors, etc.

5. Is willing to work beyond normal working hours: weekends, holidays, and other shifts/positions as necessary.

6. Attends and participates in continuing educational programs designed to keep you abreast of changes in your profession.

7. Is subject to cuts, bruises, falls, burns from equipment, odors, etc., throughout the work day.

8. May be exposed to blood borne pathogens, infectious waste, diseases, conditions, etc., including the potential exposure to the AIDS and Hepatitis B viruses.

9. Occasional overtime may be required and/or hours may be shortened as business needs dictate.

Physical Demands:

1. Must be able to handle occasional lifting and pulling.

2. Must be able to move intermittently throughout the workday to other sites, if needed.

3. Must be able to function independently, have personal integrity, and the ability to work effectively with patients, personnel, and support agencies.

4. Must be able to relate to and work with ill, disabled, elderly, emotionally upset, and at times hostile people within the facility.

EOE

Job Type: Full-time

Benefits:

• Dental insurance
• Disability insurance
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• In-person

Education:

• High school or equivalent (Preferred)

Experience:

• Medical office experience: 1 year (Preferred)

Ability to Relocate:

• Monroe, LA 71201: Relocate before starting work (Required)

Work Location: In person