Title : Personal Care Coordinator Sr.
Duration : up to 6 months
Compensation : $25.87 - $38.81 per hour
Description : The Personal Care Coordinator Sr will perform a wide variety of advanced support activities for plan members.
The incumbent will ensure regular communication of the member's annual Health Needs Assessment (HNA) or Health Risk Assessment (HRA) and care plan with the member, primary care provider (PCP) and health care team.
The incumbent will regularly assess the quality of service given to the member's care by identifying barriers and assisting in improving these barriers for all levels of care.
The incumbent will maintain strong working relationships with the PCP and health care team to ensure member access to timely services and coordination of care.
What You Will Do :
Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability.
Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department.
Maintains strong working relationships when collaborating with the PCP and health care team to ensure timely communication of member's clinical information and ensures appropriate documentation of all interventions.
Notifies member's care team of key event triggers.
Collaborates with licensed professionals in development of a care plan for each member, incorporating the HNA or HRA all assessment findings.
Facilitates communication of care plan to the PCP and member, as necessary.
Develops and implements a member's specific care plan which includes prioritized Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) goals.
Facilitates and participates in interdisciplinary team meetings as applicable.
Processes and maintains complex or sensitive documentation of member's case and care plan within health plan's medical management system.
Facilitates referrals to Behavioral Health Services and identifies the need for referrals to Long-Term Support Services and community resources.
Facilitates transfers to member's assigned case manager in accordance with member needs, when appropriate.
Anticipates longer-term and more unique member needs by providing guidance in understanding and accessing the benefits they are entitled to under Medicare and Medi-Cal, as appropriate.
Maintains compliance with established departmental productivity guidelines; compiles and conducts basic analyses and reporting of productivity metrics to management as required.
Coordinates and maintains cases in current case load in accordance with case management standards. Assists with collection of health risk or health needs assessments as well as gathers medical records as needed.
Provides regular outreach to assigned members and evaluates quality of service given to members according to department contact standards.
Serves as the main point of contact for assigned members to anticipate longer term member needs.
Works with Case Management staff to expedite the resolution of member concerns.
Completes other projects and duties as assigned.
You Will Be Successful If :
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events.
Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner.
Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees / coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office : Word, Outlook, Excel, PowerPoint) and job specific applications / systems to produce correspondence, charts, spreadsheets, and / or other information applicable to the position assignment.
What You Will Bring :
Bachelor's degree in Healthcare Management or related field preferred, High school diploma or equivalent required.
2 years of experience working with the needs of members, such as but not limited to pediatric members, seniors or persons with disabilities (SPD) and / or special populations (e.
g., homeless or at risk of homelessness) in a customer / member service capacity required.
2 years of experience with health maintenance organization (HMO), Medi-Cal and health services preferred.
Experience working with individuals with behavior health conditions or substance use disorders preferred.
Bilingual in English and one of the defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese) preferred .
About Impresiv Health :
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services.
We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do provide tangible results that add immediate value, at a rate that cannot be beaten.
Your success matters, and we know it.
That's Impresiv!