Job Description PURPOSE: As part of the ICT Team, the UM Case Management Care Coordinator is primarily responsible for assisting the Case Management Nurse with preparing cases for member outreach and care plan development.
Responsibilities include assisting with the creation of case management files, calls to members, and calls to providers for obtaining medical records.
ESSENTIAL DUTIES: Responsible for the creation of Case Management Charts.
This includes: Verifying Eligibility Obtaining initial assessments from Health Plan portals/resources.
Following up with Primary Care Physicians, Specialists, Home Health agencies/visiting nurses, and other entities to get copies of visit notes and assessments.
Referring patients to our social worker as needed.
Pulling Transition of Care Summary to Case Management File Responsible for faxing finalized care plans to Primary Care Physicians.
Responsible for mailing welcome letters and care plans to members.
Responsible for scanning and uploading documents to Case Management System.
Responsible for updated Case Management Master Log MINIMUM REQUIREMENTS Understanding of basic medical terminology Organized, efficient and possess superior attention to detail Punctual, prepared and able to meet or beat deadlines Excellent written and verbal communication skills Medical office or hospital admitting/medical records department experience a plus For Transition of Care Coordinator position – Spanish Speaker is a plus EDUCATION/TRAINING High School diploma College degree preferred On Site training will be provided LANGUAGE SKILLS Ability to communicate and speak effectively before co-workers, management, and external contacts Ability to fluently speak, write, and understand English Ability to write routine emails and other correspondence Ability to speak clearly and concisely over the telephone CONFIDENTIAL AND SENSITIVE INFORMATION: Must properly control the release of proprietary and confidential information Note that the information above is intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified.
Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.
Company Description Electronic Health Plans works collaboratively with Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members.
We work with the network’s participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment.
We coordinate patient care across all aspects of the provider network.
In this way, the Electronic Health Plans team makes its best efforts to provide high quality services to its participating physicians and superior health care to its members.