BusinessOperations - Care Coordinator II - J01000

Position Purpose:
Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.

Education/Experience:
Requires a High School diploma or GED
Requires 1 2 years of related experience



License/Certification:

For Florida-Sunshine Health Plan - All interactions with members are done telephonically.
For Arkansas Total Care plan - This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 30%. required" "Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate

Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed

Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan

Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service

May support performing service assessments/screenings for members and documenting the member s care needs

Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed

Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards

Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager

Provide education on benefits and resources available
Performs other duties as assigned.

Complies with all policies and standards.

EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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Story Behind the Need
This team supports member outreach, care coordination, and preventive health efforts for WellCare of Kentucky. These openings are driven by business need and increased workload to support outreach goals and member engagement. The team is collaborative, fast-paced, and focused on helping members access needed care and services. Key projects include VBP initiatives of outreaching members with Wellchild, Postpartum, A1C and Breast Cancer care gaps. This request is not currently tied to a larger hiring initiative, though future needs may come up based on business demand.
Typical Day in the Role
Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?	CAMERAS ARE ON FOR MOST MEETINGS Please be in a professional environment with acceptable work attire . This role focuses on outbound member outreach, care coordination support, and helping close preventive care gaps such as well-child visits, postpartum care, A1C testing, and breast cancer screenings. Day to day, team members make and receive calls, educate members, help schedule appointments, document outreach, and coordinate follow-up activities. Performance is typically measured through productivity, quality of documentation, member engagement, and success in supporting outreach goals. What makes this role unique is the direct impact on member health outcomes, the variety of outreach campaigns supported, and the opportunity to work in a fast-paced, mission-driven environment serving Kentucky members.
Candidate Requirements
Required: High School			Preferred: Certified CHW community Health Worker
Required:			Preferred: LPN
Years of experience required: 1-2 years of related experience. Outbound member outreach, community resource knowledge, medical/clinical knowledge, provider scheduling, community resource knowledge , remote experience Due to upgraded security for this team the contingent workers need to have an updated phone. IOS 17 for Apple and 13 for Android Disqualifiers: Only has call center experience, doesn t have any outbound call or heavy medical experience. Position longevity/reliability (please state if contract AND IF COMPLETED) Additional qualities to look for: able to build rapport quickly, adaptable, reliable, strong communication skills, Healthcare or community based support experience
Top 3 must-have hard skills stack-ranked by importance	1	Outbound call handling and member outreach experience & provider scheduling
	2	Accurate documentation and data entry in multiple systems , tech savvy, ability to document/chart while speaking
	3	Appointment scheduling and care coordination support for SDOH resource needs, great communication skills verbally and written , active listening skills
Candidate Review & Selection
Shortlisting process Candidate review & selection Interview information Onboard process and expectations	Projected Manager Candidate Review Date:			1-2 days post shortlisting
	Type of Interviews:			Teams CAMERA ON
	Required Testing or Assessment (by Vendor):			Basic computer skills test
Next Steps