L.A. Care Health Plan
Care Management Coordinator II (ALD)
L.A. Care Health Plan, Los Angeles, California, United States, 90079
Overview
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we ensure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County’s vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary
The Care Management Coordinator II is responsible for outreach to members/caregivers, providers, Community Based Organizations (CBO), and others to help enroll our highest-need members into the Care Management (CM) and Disease Management (DM) programs. The position assesses member strengths, challenges, needs, and barriers to care through conducting telephonic Health Risk Assessments (HRA). It works with the member/caregiver, Care Management Specialist, Community Health Worker, and the Interdisciplinary Care Team (ICT) to support the development and implementation of the care plan and address unmet needs. This position coordinates the flow of information between the CM team and the member/caregiver, provider, medical group, and other ICT members. It supports coordination of member care as instructed by the Care Management Specialist and outlined in the care plan, including reinforcement of health education and disease management information; coordinating benefits such as transportation and DME; and linking the member to community resources to address the Social Determinants of Health (SDoH). The position ensures the CM team meets contractual and regulatory requirements and timelines by maintaining accurate documentation and following up with the member and provider as needed. The position may be assigned projects to support the department in meeting regulatory and contractual requirements, such as running reports, data validation, quality checks and other projects. The position assists with communication and coordination between programs and maintains confidentiality when communicating member information. Duties
Responsible for time-sensitive processes for initiating cases, managing referrals to the department, appropriate documentation, routing of information, data entry, faxing, emailing, filing of confidential member information, and maintaining logs of activity. (40%) Engages members to participate in the CM/DM programs by reaching out and promoting the programs to address unmet needs. (10%) Completes telephonic calls to conduct the HRA with high-risk members in the CM program. Assists the care team with developing and assessing health interventions. (10%) Conducts telephonic outreach calls to members/caregivers regularly and evaluates and documents progress toward healthcare goals. Collaborates with the Care Management Specialist to set up provider/specialist appointments and follow up on treatment plans. (10%) Handles incoming and outgoing calls to members/caregivers and providers to coordinate care as identified in the care plan. (10%) Initiates follow-up calls to members to administer screenings or confirm linkage to appropriate resources. Provides general information to members and providers about the CM and DM programs. (10%) Performs other duties as assigned. (10%) Education & Experience
Education Required:
High School Diploma or High School Equivalency Certificate Education Preferred:
Associate’s Degree Experience Required:
At least 6 months of experience in an administrative and customer service role in a health care/health services setting. Preferred:
1 year of Medical Assistant experience; 6 months of experience processing authorizations at a managed care/health plan setting. Skills and Certifications
Required:
Knowledge of medical terminology; strong verbal and written communication skills; proficiency in Microsoft Office with a high level of accuracy; excellent organizational and time management skills; detail-oriented and a team player; excellent customer service skills with compassion and empathy; ability to demonstrate sensitivity and respect for the opinions, perspectives, customs, and individual differences of others; ability to value diversity and interact with people from diverse backgrounds; ability to be flexible, open-minded, listen to and consider others’ viewpoints; ability to work well and develop effective relationships with diverse personalities. Preferred:
Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable: English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses & Certifications
Required:
Licenses/Certifications as applicable Preferred:
Certified Medical Assistant (CMA) Training
Preferred:
Motivation Interviewing; Trauma Informed Care Physical Requirements
Light Additional Information
Salary Range Disclaimer: The expected pay range is based on factors such as geography, experience, education, and the market. The range is subject to change. This position is a limited duration position with a term of a minimum of one year and a maximum of two years from the start date unless terminated earlier by either party. Limited duration positions are full-time and eligible to receive full benefits. L.A. Care offers a wide range of benefits including: Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Medical Assistant, Public Health, Healthcare Equal Opportunity Employer: L.A. Care is committed to the principles of diversity in the workplace. L.A. Care Health Plan, A Public Entity © 2000-2021
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Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we ensure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County’s vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary
The Care Management Coordinator II is responsible for outreach to members/caregivers, providers, Community Based Organizations (CBO), and others to help enroll our highest-need members into the Care Management (CM) and Disease Management (DM) programs. The position assesses member strengths, challenges, needs, and barriers to care through conducting telephonic Health Risk Assessments (HRA). It works with the member/caregiver, Care Management Specialist, Community Health Worker, and the Interdisciplinary Care Team (ICT) to support the development and implementation of the care plan and address unmet needs. This position coordinates the flow of information between the CM team and the member/caregiver, provider, medical group, and other ICT members. It supports coordination of member care as instructed by the Care Management Specialist and outlined in the care plan, including reinforcement of health education and disease management information; coordinating benefits such as transportation and DME; and linking the member to community resources to address the Social Determinants of Health (SDoH). The position ensures the CM team meets contractual and regulatory requirements and timelines by maintaining accurate documentation and following up with the member and provider as needed. The position may be assigned projects to support the department in meeting regulatory and contractual requirements, such as running reports, data validation, quality checks and other projects. The position assists with communication and coordination between programs and maintains confidentiality when communicating member information. Duties
Responsible for time-sensitive processes for initiating cases, managing referrals to the department, appropriate documentation, routing of information, data entry, faxing, emailing, filing of confidential member information, and maintaining logs of activity. (40%) Engages members to participate in the CM/DM programs by reaching out and promoting the programs to address unmet needs. (10%) Completes telephonic calls to conduct the HRA with high-risk members in the CM program. Assists the care team with developing and assessing health interventions. (10%) Conducts telephonic outreach calls to members/caregivers regularly and evaluates and documents progress toward healthcare goals. Collaborates with the Care Management Specialist to set up provider/specialist appointments and follow up on treatment plans. (10%) Handles incoming and outgoing calls to members/caregivers and providers to coordinate care as identified in the care plan. (10%) Initiates follow-up calls to members to administer screenings or confirm linkage to appropriate resources. Provides general information to members and providers about the CM and DM programs. (10%) Performs other duties as assigned. (10%) Education & Experience
Education Required:
High School Diploma or High School Equivalency Certificate Education Preferred:
Associate’s Degree Experience Required:
At least 6 months of experience in an administrative and customer service role in a health care/health services setting. Preferred:
1 year of Medical Assistant experience; 6 months of experience processing authorizations at a managed care/health plan setting. Skills and Certifications
Required:
Knowledge of medical terminology; strong verbal and written communication skills; proficiency in Microsoft Office with a high level of accuracy; excellent organizational and time management skills; detail-oriented and a team player; excellent customer service skills with compassion and empathy; ability to demonstrate sensitivity and respect for the opinions, perspectives, customs, and individual differences of others; ability to value diversity and interact with people from diverse backgrounds; ability to be flexible, open-minded, listen to and consider others’ viewpoints; ability to work well and develop effective relationships with diverse personalities. Preferred:
Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable: English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses & Certifications
Required:
Licenses/Certifications as applicable Preferred:
Certified Medical Assistant (CMA) Training
Preferred:
Motivation Interviewing; Trauma Informed Care Physical Requirements
Light Additional Information
Salary Range Disclaimer: The expected pay range is based on factors such as geography, experience, education, and the market. The range is subject to change. This position is a limited duration position with a term of a minimum of one year and a maximum of two years from the start date unless terminated earlier by either party. Limited duration positions are full-time and eligible to receive full benefits. L.A. Care offers a wide range of benefits including: Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Medical Assistant, Public Health, Healthcare Equal Opportunity Employer: L.A. Care is committed to the principles of diversity in the workplace. L.A. Care Health Plan, A Public Entity © 2000-2021
#J-18808-Ljbffr