Seeking Clinical Care Coordinators (licensed Registered Nurses) to join our team based in the District of Columbia. This position primarily offers remote work opportunities.
Responsibilities
Manage a caseload as assigned by Care Management Leadership.
Conduct regular contact with enrollees based on their needs and care plan.
Perform face-to-face visits at enrollee's homes, physician's offices, or other agreed locations as necessary.
Assess enrollees regularly to identify needs, barriers, and gaps in care, ensuring timely interventions.
Complete care coordination activities with a focus on quality, timeliness, and adherence to company policies and standards.
Collaborate with SeniorCare Manager to prioritize cases, set objectives, and address utilization concerns.
Document enrollee interactions accurately and promptly in accordance with organizational policies.
Ensure compliance with company confidentiality policies regarding enrollee information.
Participate in discharge planning activities and contribute to discharge plans based on enrollee needs and available healthcare resources.
Communicate effectively verbally and in writing with enrollees, caregivers, and healthcare providers.
Educate enrollees on EPSDT and promote compliance with preventive medical and dental services.
Apply advanced knowledge of conditions and standard care approaches to manage assigned enrollees effectively.
Coordinate follow-up care with vendors or contracted providers based on reports of service visits.
Refer enrollees to appropriate vendors for durable medical equipment (DME) and assistive technology use.
Assist enrollees in planning transitions of care across various healthcare settings and systems.
Enter service authorizations as required by Care Management staff.
Use communication skills to foster understanding and collaboration among enrollees, families, providers, and other stakeholders.
Maintain a professional, courteous, and customer-focused demeanor in all interactions.
Demonstrate proficiency in medical terminology and healthcare delivery systems.
Apply effective time management and organizational skills.
Qualifications
Three to five years of related experience in managed care and/or care management.
Three to five years of experience in clinical or community resource settings.
Effective verbal and written communication skills.
Bilingual proficiency in Spanish preferred.
Familiarity with medical terminology.
Proficiency in Microsoft Office suite and other computer applications.
Strong organizational and decision-making skills.
Ability to work under pressure, meet deadlines, and maintain a positive attitude while delivering exemplary customer service.
Ability to participate in professional, multidisciplinary meetings.
License/Certifications
Licensed in DC as a Social Worker (LICSW) or Registered Nurse (RN).
Occasional weekend, evening, or early hours may be required to accommodate member needs.
Equal Opportunity Employer
An Equal Opportunity Employer. We value diversity and do not discriminate on the basis of race, creed, color, religion, gender, sexual orientation, gender identity, pregnancy, national origin, citizenship status, age, disability, genetic information, marital status, veteran status, criminal records (sealed or expunged), arrest records (not resulting in conviction), or any other characteristic protected by federal, state, or local law.
Employment Type: Full-Time
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Other
Industries
Human Resources Services
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