West Suburban Medical Center COORD, PATIENT CARE in Encino, California
COORD, PATIENT CARE (Job Number: 1605051107)
- Collaborates with CalOptima PCC to ensure timely communication of member’s clinical information.
- Effectively interview members to determine the client’s strengths, problems, functional status, goals and need for specific services/resources.
- Remain knowledgeable of OneCare’s benefit structure. Guide members in understanding and accessing the benefits they are entitled to under Medicare and Medi-Cal, through the OneCare program.
- Assist with coordination of member’s health care and social service needs both within and outside the Medical Group and CalOptima.
- Develop rapport, establish and maintain effective interpersonal relationships with internal and external contacts at all levels. Expedite the resolution of member and Provider concerns.
- Communicate effectively, both verbally and in writing with individuals from varying cultural and ethnic backgrounds. Knowledgeable principles and techniques to serve populations in diverse social and ethnic groups.
- Facilitate communication of initial care plan to the primary care physician (PCP), PMG CalOptima and member, as indicated.
- Assist member in meeting their preventive care goals (ie. HEDIS measures, Evidence Based Outcome Measure activities).
- Assist member with scheduling of appointments.
- In collaboration with clinician and Social Workers, facilitate referrals to LTSS, behavioral health and community resources.
- Initiate referrals to both internal and external care management departments and other department/government or community agencies
- Facilitate warm transfers to member’s assigned case manager or social worker in accordance with member needs, when appropriate.
- Notify member’s care team of key event triggers (ie. transitions of Care, falls, unsafe home)
- Outreach to members to complete assessment when there are changes to a member’s health status (i.e. key events)
- Assist in scheduling and participating in ICT meetings, as appropriate.
- Prompt communication of member’s case notes, HRA, care plan and interdisciplinary care team (ICT) proceedings to CalOptima’s PCC for integration in CalOptima’s medical management system.
- Maintain accurate records and documentation.
- Maintains and keeps in total confidence, all files, documents and records that pertain to the operation of business of Cap Management Systems.
- Attends all mandatory trainings
- All other job related duties as it relates to the job function or as delegated by the management team.
- Associate Degree or Bachelor’s preferred. High School diploma or GED may be considered if equivalent clinical experience documented. Medical Assistant preferred. Equivalent clinical work experience considered.
- One year Managed care experience (HMO, Medi-Cal/Medicare, Long Term Services and Supports and Community Health services) preferred. Experience in customer service. Preferably with proficient EzCap, Word, Excel computer skills. Excellent written and verbal communication skills. Problem solving and analytical skills. Ability to speak second language is preferred
Primary Location: CA-Encino
Organization: Conifer Value Based Care