The Community Care Coordinator (CCC) works collaboratively with the health care team to manage and coordinate care for members that have social needs in order to ensure quality and cost-effective patient-centered care. This position also works directly with members/clients as well as with staff, managers, internal and external customers.
Duties and Responsibilities
Responsibilities include, but are not limited to, the following:
Under the direction of a Medical Case Manager, performs ongoing care coordination activities. This includes:
Conducting outreach
Completing HRA and initial health screening
Providing telephonic initial screen of non-medical needs, coordinates services and makes appropriate referrals
Providing information to members/clients and/or their families regarding social and community support
Assist with calls to various social service agencies as appropriate
Off site visits (such as but not limited to home, hospital or community health centers or other community agencies) as necessary or required
Supporting members to obtain access to care and services and making appointments
Aid in obtaining medically necessary DME
Directing members/clients to internal departments as appropriate
Managing a case load of identified and/or assigned members
Providing comprehensive documentation of all activities and contacts in CMAQE or appropriate software system
Assist Medical and/or Integrated Care Managers in coordinating community resources as appropriate
Participate in the development and maintenance of community resource database
Calculate cost savings that may result from interventions, where an alternative level of care, service or resource has been identified and/or arranged
Responsible for, identify, and, pursue opportunities for professional development
Recommend and participate in the development of program improvements and QI activities
Serve as resource to respond to questions from ancillary departments within Neighborhood
Participate in community events and projects as assigned
Provide cross coverage as assigned by Lead and/or Manager
Participate in Outreach/Marketing activities as needed and appropriate
Maintain up-to-date knowledge of resources in Rhode Island
Other duties as assigned
Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents
Qualifications
Required:
Preferred:
Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
Neighborhood's employees come from a diverse background but all are committed to creating a more equitable health care system. Our array of experiences allows us to have a broad perspective and great creativity in facing whatever challenges arise. Unlike many other health insurance companies, we have nearly 30 nurses and social workers on staff. This structure speaks to our focus on active and compassionate care management for our members; we know that people who are alienated from the health care system require additional advocacy, outreach and support.
Neighborhood offers an exceptional compensation package to employees. We annually review base salaries/benefits and adjust as appropriate.