Inpatient Coordinator - Honolulu, United States - AlohaCare

Description

Job Description

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The Company:

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii's third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.

The Culture:

AlohaCare employees share a passion for helping Hawaii's most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication, and a generous benefits package.

AlohaCare's leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii's families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect, and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare's comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

Position Summary:

The primary role of the Inpatient Coordinator is to engage and build relationships with members and providers to improve health outcomes. Inpatient Coordinators will educate and assist actively enrolled AlohaCare members on how to navigate their health plan benefits. Most of the Inpatient Coordinator's time will be spent in the facility setting, conducting face-to-face visits with members who are unable to reach or have a difficult discharge disposition. The Inpatient Coordinator connects our members with community resources and collaborates with AlohaCare's Clinical Teams to assist with safe discharge of members with difficult dispositions.

Primary Job Duties and Responsibilities:

• Act as a liaison between the hospital, PCP, and AlohaCare clinical teams.
• Engage as needed with members and providers in the hospital setting (Medical and Behavioral) and proactively identify needs to support the member during and after the discharge process to assist with safe discharge.
• Identify reasons and/or contributing factors for admission that will be challenges post discharge.
• Conduct appropriate assessments timely via face-to-face hospitalization visits and keep close communication with the Utilization Review Nurse.
• Identify disabilities and Social Determinants of Health needs (Substance/Tobacco Use, BH, Housing, Food Insecurity, etc.) and connect member to Community Resources in their neighborhood or area or utilize the Unite Us tool.
• Send Aid to Disability Review Committee (ADRC) referrals as appropriate.
• Under clinical supervision, the Inpatient Coordinator interacts with members, their family, physician(s), and other providers to assist in determining the member's status and capacity to assess the options for service delivery including use of health plan benefits and community resources to update the care team.
• Assist the member in finding a safe discharge disposition such as accepting Skilled Nursing Facility, Intermediate Care Facility, Foster Care Home, Temporary or long-term housing, etc.
• Assist the Utilization Review nurse with coordinating the discharge needs (i.e. Durable Medical Equipment, Home Health Services, or prescriptions) for safe discharge.
• Execute planned intervention(s) as directed, which include but are not limited to facilitating timely access to services, addressing barriers to care and medications, identifying and providing transportation assistance as needed, etc., on behalf of the member and provider.
• Assist with visiting Unable to Reach (UTR) members while such members are hospitalized.
• Assist in communicating to the hospital case managers the need to complete forms/applications and other necessary documentation for other programs that can assist the member such as 1147, 1148, 1157and 1127 forms.
• Complete and submit Going Home Plus referrals for members who are in-patient for 60+ consecutive days.
• Proactively coordinate discharge follow up appointments for members prior to their discharge.
• Improve provider attribution and/or discharge follow up.
• Reduce unnecessary readmissions.
• Collect and communicate demographic and contact information post discharge.
• Collaborate with hospital care team to support timely member discharges and remove barriers.
• Collaborate with Community Health Centers and other provider offices to support their AlohaCare patients with care coordination needs to improve health outcomes.
• Assist the member in maintaining eligibility and connections with other entitlement programs the member may qualify for.
• Coordinate with AlohaCare Health Coordination staff, and appropriate operational departments/units, as required by the member's needs (e.g., Utilization Management, Transition of Care, Disease Management, Service Coordination, Travel, etc.), and network physicians/providers to ensure services are in place (when applicable).
• Complete scheduled and assigned daily activities on the activity log within the Health Edge Guiding Care Management system. Document activities in the Health Edge Guiding Care Management system.
• Participate in Daily Rounds meetings, and Long Length of Stay Rounds meetings weekly providing information for members in assigned hospitals.
• Generate and create reports as needed.
• Ability to complete multiple tasks to ensure timeliness standards are met.
• Other duties as assigned by supervisor and/or manager.
• Responsible to maintain AlohaCare's confidential information in accordance with AlohaCare policies, and state and federal laws, rules, and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Required Competencies & Qualifications:

• High School Diploma

• Minimum one (1) year to 2 years of Member Outreach, Care Coordination, Managed Care, Health Care and or previous Health Plan with direct member support experience.

• Experience with serving members in the community.

• Health plan experience with care coordination responsibilities

• Strong verbal and written communication in English.

• Strong Customer Service Skills

• Requires operation of general office equipment to include PC, Surface Pro 3, fax/copy machine and company phone. Intermediate skill using Microsoft Programs; Word, Excel, Outlook, and PowerPoint.

• Possession of a valid driver's license and auto insurance with access to a reliable, 4-wheel, safety- inspected vehicle.

• TB Clearance

• First Aid and CPR Certification

Preferred Competencies & Qualifications:

• Associate's degree or previous equivalent healthcare experience preferred.

• Bachelor's degree in human services, Sociology, Psychology, or other related field.

• Three (3) years of Care Coordination, outreach, and customer experience

• Bilingual in Ilocano, Tagalog and/or Korean preferred.

• Experience with individuals who have special health care needs, including HIV/AIDS, developmental disabilities, medically fragile, older adults, and individuals with physical disabilities.

Physical Demands/Working Conditions:

• Medium work: Walking, standing, and exerting up to 40 pounds of force occasionally, or up to 25 pounds of force frequently, or greater than negligible up to 10 pounds of force constantly to move objects.
• May require prolonged sitting or standing up to 8 hours.
• Requires operation of a computer workstation, including keyboard and video display terminal.

Salary Range: $ $32.00 an hour

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans' status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.