Mgd Care Coordinator - Floater

Job Title: Mgd Care Coordinator

Location: Durham, NC 

Duration: 6 months

What is the schedule for this job? Monday - Friday, 8:00 am - 5:00 pm, with occasional overtime

Pay Range: $30 to 35/Hr.

Pre-Screening Question:

• Mention how you ensure timely documentation to speed up insurance approvals and prevent care delays 
• What is your experience with managed care principles, utilization management, or insurance authorizations?" 
• How do you prioritize your daily caseload when multiple patients have urgent needs at the same time?

About the role:

Responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract 

Key Responsibilities of the Job:

• Responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract. Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's program needs. Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. The process does not involve clinical judgment. Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of services. Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, and physicians. Identifies members that would benefit from expanded services. Requires BA/BS degree and a minimum of 1 year of experience working directly with people related to the specific program population or other related community based organizations; or any combination of education and experience which would provide an equivalent background. BA/BS degree field of study in health care related field preferred. Specific education and years and type of experience may be required based upon state law and contract requirements. Travels to worksite and other locations as necessary. For MMP, requires Community Health Worker certification to be obtained within one year of employment.
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Mandatory requirements:

• Field (spends 4-5 days per week in-person with patients, members, or providers. 
• Requires BA/BS degree and a minimum of 1 year of experience working directly with people related to the specific program population or other related community based organizations.
• Field-based position. Travels to worksite and other locations as necessary.
• Monday - Friday, 8:00 am - 5:00 pm, with occasional overtime