BUILDING A WORKFORCE

Community Care Coordinator

Neighborhood Health Plan

Multiple Positions Available!

Smithfield, RI

Overview:

This position 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. He/she works directly with members/clients as well as with staff, managers, internal and external customers.

Responsibilities:


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
Providing assistance 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
Providing assistance in obtaining access to care and services and making appointments
Providing assistance 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
Assists Behavioral Health Case Manager in coordinating community resources as appropriate
Participates in the development and maintenance of community resource database
Collaborates with and provides support to Medical Case Managers as necessary
Calculates cost savings that may result from interventions, where an alternative level of care, service or resource has been identified and/or arranged
Takes responsibility for, identifies, and, pursues opportunities for professional development
Recommends and participates in the development of program improvements and QI activities
Serves as resource to respond to questions from ancillary departments within Neighborhood
Participate in communities as assigned
Provides cross coverage as assigned by Supervisor
Participates 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:

Associates Degree in human service related field or equivalent years of background and experience to equal degree
Three (3) to Five (5) years’ experience in medical or social services setting
Experience working with the needs of individuals with behavioral health and/or long term care needs
Strong oral and written communication skills
Strong customer service orientation
Strong interpersonal skills
Strong organizational skills
Ability to problem solve and work independently
Strong collaborative skills and teamwork values
Computer literacy with windows based programs
Sound judgment
Strong time management skills
Ability to keep accurate records and prepare reports
Ability to work with minimal supervision
Flexible schedule including evenings and weekends
Ability to travel for work, must have access to reliable transportation and/or valid driver’s license and proof of insurance

Preferred:

Clinical specialty experience
Knowledge of community social service resources, State agencies and the state Medicaid program
Knowledge of medical terminology
Bilingual

Neighborhood is an Affirmative Action and Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, genetic information, age, disability, veteran status or any other legally protected basis.

Neighborhood is committed to ensuring individuals with disabilities and/or those who have special needs participate in the workforce and are afforded equal opportunity to apply for jobs. If you would like to contact us regarding the accessibility of our Website or need assistance completing the application process, please contact us at recruiting@nhpri.org.