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Care Coordinator

Nashville, TN · Healthcare
Care Coordinator – Primary Care Clinic
Nashville, TN

*** This is a Full-Time, Benefits Available, CONTRACT position expected to last 6 months or longer ***

Care Coordinator Job Summary:
  • Coordinates follow-up care plans by scheduling needed appointments or enrolling member in related programs
  • Assesses member compliance with medical treatment plans, identifying any barriers and coordinating resolution to ensure that members receive appropriate care, at the appropriate level, in a timely manner
  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
  • Provides information regarding network providers or general health plan or program information when requested
  • As needed, administratively assist with the review of complex cases
  • In conjunction with case management nurse and providers, makes recommendations to adjust or modify treatment plan and/or determines need for additional services
  • Serves as a liaison between the Medical Management departments (CM/UR/QI, etc) and Health Plan Operations or other internal departments
  • Investigate inquiries, follow up on them, and document actions required to service inquiry
  • Assists customers in navigating relevant websites and encourage and reassure them to become self-sufficient
  • Identifies and refers members to appropriate local, state or federal programs

Care Coordinator Background:  
  • Requires an education level of at least a high school diploma or GED; Associate’s or Bachelor’s degree is a plus.
  • Prefers, but does not require, a Medical Assistant certification (CMA or RMA).
  • Requires exceptional phone / customer service skills, as well as very strong computer user skills.
  • At least 3-5 years’ Care Coordination experience, preferably in home health or provider setting, or other healthcare support role with heavy computer & phone use.
  • Requires 1 or more years at a Managed Care Organization (Health Plan, IPA/Medical Group, HMO, TPA/MSO, etc).
  • Requires basic to intermediary familiarity with Medical terminology (1-3 years direct experience).
  • Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product.
  • Knowledge of health care delivery system, Medicaid/Medicare and related state programs is required.
  • Computer skills to include Microsoft Word, Excel and basic data entry, including the ability to learn new and complex computer system applications.
  • Must have a minimum of 40 wpm typing with a high level of accuracy.
  • Strongly prefer Bilingual in English and Spanish.

623.201.8732 (CALL – TEXT – FAX)
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