Note: The job is a remote job and is open to candidates in USA. CareSource is a healthcare organization dedicated to supporting individuals through coordinated care. The Integrated Duals Program Coordinator I plays a vital role in ensuring timely service delivery and enhancing member satisfaction through effective outreach and engagement with members and providers.
Responsibilities
- Understand and effectively demonstrate comprehensive person-centered thinking
- Conducts outreach to members and providers to confirm service details, coordinate scheduling, address general inquiries, and ensure accurate documentation of care coordination activities. Coordinate across diverse services by working with providers, community partners, and member/ caregivers to manage scheduling, service updates, and administrative changes, as needed
- Serves as a support resource for member and provider increase, request, escalations, or concerns by coordinating responses and ensuring issues are routed or addressed promptly
- Proactively identify and collaborate with care managers, providers, and other partners as needed to support member services and ensure smooth communication and continuity across care activities
- Monitor service delivery to ensure appropriateness of care and compliance with any waiver
- Gather and document service-related information during members interaction to support diverse specialty care coordination, service planning, or referral processes
- Maintain accurate documentation and maintenance of member records and alignment with regulatory standards, ensuring timely distribution to appropriate internal teams or provider partners as needed
- Follow established standards of practice, internal policies, and procedures to ensure compliance with contractual obligations and applicable regulatory requirements
- Identify member and provider needs and facilitate referrals to appropriate internal teams such as care management or community-based support programs
- Engage members through participating in information collection and assertive remote outreach to assist with comprehensive care coordination activities to support effective member outcomes
- Provide basic education to members and providers on available benefits and resources; escalates complex needs or urgent issues to the rapid response team for immediate follow up and coordination. Document care coordination activities and member response in a timely manner according to standards of practice and CareSource policies regarding professional documentation
- Look for ways to improve the process to make the members experience with CareSource easier and share with leadership to make it a standard, repeatable process
- Performs any other job related duties as requested
Skills
- High School or GED required
- One (1) year of experience working in healthcare required
- Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
- Ability to communicate effectively with a diverse group of individuals
- Ability to multi-task and work independently within a team environment
- Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
- Strong advocate for members at all levels of care
- Strong understanding and respect of all cultures and demographic diversity
- Ability to interpret and implement current research findings
- Awareness of community & state support resources
- Critical listening and thinking skills
- Decision making and problem-solving skills
- Strong organizational and time management skills
- Two (2) years of experience working in healthcare preferred
Benefits
- Bonus tied to company and individual performance
- Substantial and comprehensive total rewards package
Company Overview
CareSource provides managed care services to Medicaid beneficiaries. It was founded in 1989, and is headquartered in Dayton, Ohio, USA, with a workforce of 1001-5000 employees. Its website is https://www.caresource.com/.
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