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Case Management Coordinator - Doral, United States - SOLIS Health Plans
Description
Job Description Job Description Case Management Coordinator
Position is fully onsite Mon-Friday, Bilingual in Spanish is requiredLocation: 9250 NW 36th St, Miami, FL 33178About usSolis Health Plans is a new kind of Medicare Advantage Company.
Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey.
Our team consists of expert individuals that take pride in delivering quality service.We believe in a culture that collaborates and supports one another, and where success is interlinked, and each employee is valued.
POSITION SUMMARYCase Management Care Coordinators are instrumental in helping members manage their health by serving as a liaison between the health plans Case Management Department and the members health care providers.
Case Management Care Coordinators perform their duties as an extension of the case management team to ensure components identified as part of the members care are addressed and arranged.
The Case Management Care Coordinator provides support by outreaching to members and ensuring their needs are met.In addition, the Case Management Care Coordinator will gather key elements of information that will allow others within the department as well as other departments to provide exceptional customer care through attention to detail, attentive and empathetic communication, and follow-up that may be needed for optimal healthcare experiences.
This requires a flexible attitude, quick thinking and a caring disposition.Day-to-day activities may vary based on member needs and departmental requirements, but can involve the following tasks and responsibilities:ESSENTIAL DUTIES & RESPONSIBILITIESPerforms member screening through health risk assessment completionCompletes interventions as determined by members individualized care planSchedules appointments in support of care plan goalsAbility to professionally communicate with nurses and physicians both internal and external to organizationHandles inbound calls and answers member questionsConnects with members via phone as well as alternate communication methodsIs familiar and coordinates with community resources that will support interventions on members individualized care planAbility to document within the members electronic recordAssist the case management team with support and follow-up of interventions and actionsEnsures compliance with all regulatory requirements inclusive of HIPAA, OSHA, and other federal, state, and local regulationsHelps with data collectionMaintains a polite and professional demeanor at all timesMaintains patient confidentiality at all timesMust be able to work within a high-paced and demanding environmentMust be able to multi-task and prioritize appropriatelyAssists with training of new staff membersPerforms other duties and projects as assignedQUALIFICATIONS & EDUCATIONThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.The noise level in the work environment is usually moderate.
Fast-paced office environment.
Highly regulated environment.
Time frames are in accordance with CMS, NCQA, and internal operations/ compliance driven.
Interact with providers, staff, visitors, government agencies, etc., under a variety of conditions and circumstances.
This work requires the following physical activities:
climbing, bending, stooping, kneeling, twisting, reaching, sitting, standing, walking, lifting, finger dexterity, grasping, repetitive motions, talking, hearing and visual acuity.
The work is performed indoors. Sits, stands, bends, lift, and moves intermittently during working hours.PHYSICAL DEMANDSThe 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 accommodations may be made to enable individuals with disabilities to perform the essential functions.The employee must be able to frequently lift up to 30 pounds and occasionally lift and/or move up to 50 pounds.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand and walk.The employee is occasionally required to use hands to finger, handle, or feel; reach with hands and arms; climb or balance and stoop, kneel, crouch, or crawl.
Specific vision abilities required to this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
LANGUAGE REQUIREMENTSBilingual English/SpanishPERFORMANCE MEASUREMENTSDuties accomplished timely and efficientlyAttendance/punctualityCompliance with company and regulatory agency regulationsSafety and securityQualityThis Job Description may be modified at any time at the discretion of the employer as business operations may deem necessary.
This does not constitute an employment agreement and may not include all duties.The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position.
They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.
The incumbent must be able to work in a fast-paced environment with a demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate.
Solis Health Plans provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Job Type:
Full-timeBenefits:401(k) & 401(k) matchingDental insuranceDisability insuranceEmployee assistance programFlexible scheduleHealth insuranceLife insurancePaid time offVision insurance#J-18808-Ljbffr
