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Service Coordinator - PCHP
Service Coordinator - PCHPParkland Health and Hospital System (PHHS) • Dallas, TX, United States
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Service Coordinator - PCHP

Service Coordinator - PCHP

Parkland Health and Hospital System (PHHS) • Dallas, TX, United States
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Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission : the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that's served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It's our passion.

Primary Purpose :

Responsible for daily service coordination (SC) (case management and care coordination) for health plan members. Ensures a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote patient safety, quality of care, and cost-effective outcomes.

Why Parkland Health?

At Parkland Health, we believe that our success is built on the dedication, passion, and unique perspectives of our team members. When you join us, you're not just starting a job - you're beginning a meaningful career that supports your personal growth and professional aspirations.We are committed to fostering a workplace where every individual is encouraged to reach their full potential. At Parkland, you'll have the opportunity to work alongside passionate professionals in nationally recognized specialty areas, and be part of a culture that supports learning, collaboration, and innovation.Our team members don't just work here-they thrive here, making a lasting impact on the health and well-being of the communities we serve. Join us, and see why your career matters here!

Inside the Parkland Culture

Benefits :

  • Medical - Active Day 1 of hire
  • Dental
  • Vision
  • Life Insurance
  • Disability Insurance
  • Mandatory Savings Plan
  • Flexible Spending Accounts
  • Paid Personal Leave
  • Tuition Reimbursement
  • Employee Health Center
  • And more!

Job Summary : Service Coordination

  • Conducts service coordination and care management activities according to model of care, program description and policies and procedures to provide timely, quality care and services to members with physical and / or behavioral health needs.
  • Evaluates member needs and available resources to facilitate the development of a care plan that will contribute to the best health outcomes for the member / family.
  • Monitors care plans, member status and outcomes and provides recommendations to care plan based on identified member needs and goals, as applicable.
  • Coordinates between the member and / or family / caregivers and the provider care team, as applicable, to ensure member accessibility to identified services.
  • Completes case interventions according to time and completeness requirements and documents all actions and decisions.
  • Maintains directory of community resources and provides resource support to members and their families / caregivers.
  • Provides education to members and their families / caregivers on procedures, provider instructions, treatment options, referrals, and healthcare benefits, including behavioral health.
  • Functions as liaison with member's providers.
  • Quality

  • Integrate health literacy principles into all communication including Members and Providers.
  • Support strategies that meet clinical, quality and network improvement goals.
  • Promote the use of Health Information Technology to support and monitor the effectiveness of health and social interventions and make data-driven recommendations as needed.
  • For staff in clinical roles, foster collaborative relationships with members and / or providers to promote and support evidence-based practices and care coordination.
  • Regulatory and Compliance

  • Ensures work is carried out in compliance with regulatory and / or accreditation standards as well as contractual requirements.
  • Participates in self-audits and peer reviews to ensure compliance with regulations, standards, and departmental policies and provide feedback for the Service Coordination training program.
  • Professional Accountability

  • Promotes and supports a culturally welcoming and inclusive work environment.
  • Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values.
  • Adheres to organizational policies, procedures, and guidelines.
  • Completes assigned training, self-appraisal, and annual health requirements timely.
  • Adheres to hybrid work schedule requirements.
  • Attends required meetings and town halls.
  • Recognizes and communicates ethical and legal concerns through the established channels of communication.
  • Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information.
  • Maintains confidentiality at all times.
  • Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies.
  • Proficient in medical and managed care terminology.
  • Competent in the application of integrated service coordination (care management) standards.
  • Familiar with auditing processes and regulatory / accreditation requirements (TDI, HHSC, NCQA, CMS).
  • Proficient computer and Microsoft Office skills. Ability to learn new software programs,
  • Knowledge of Texas Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual.
  • Minimum Qualifications :

  • BSN Degree from and accredited Professional School of Nursing - OR - Master of Social Work (MSW) Degree from an accredited program.
  • For roles primarily serving members with behavioral healthconditions, master's degree in social work, or related field preferred.
  • At least 3+years of experience practicing behavioral health (social work, counseling, etc.) is required.
  • 3+ years of care management experience in a health plan setting or managed care organization is preferred.
  • Equivalent Education and / or Experience :

  • May have an equivalent combination of education and / or experience in lieu of specific education and / or experience as stated above.
  • Certification / Registration / Licensure :

  • Must have and maintain current, valid RN license or temporary RN license from the Texas Board of Nursing, or valid Compact RN license or LBSW, LMSW, or LCSW.
  • If primarily serving members with Behavioral Health conditions, must have a valid RN license from the Texas Board of Nursing or compact RN license or LPC, LMFT, LBSW, LMSW or LCSW in the State of Texas.
  • Certified Case Manager (CCM) credential in case management preferred.
  • Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.As part of our commitment to our patients and employees' wellness, Parkland Health is a tobacco and smoke-free campus.

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