BusinessOperations - Community Resource Coordinator II - J01010

Mindlance

  • Remote-MO, MO
  • 1 day ago
  • Remote

    Highlights

    The purpose of our team is to reduce readmissions, potentially preventable events at the emergency room, ensure members are connected to transportation and ancillary services as needed for medical care or social needs, work with parents/providers or children with elevated blood lead levels to identify source of lead and help blood lead levels trend downward, coordinate with LPHAs for treatment of any member suspected with tuberculosis, and partner with rural medical hubs for the state s Transformation of Rural Community Health program. What makes the Community Resource Coordinator role unique is its integration of care coordination, public health, and community partnership efforts, proactively addressing medical, behavioral, social, and environmental barriers to care through initiatives that reduce preventable emergency department, support transportation and social needs, and connect members to innovative rural health resources and community-based services.

    Numbers & Facts

    LocationRemote-MO, MO (
    Remote
    )

    Description

    Position Purpose:
    Supports community connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and supports the care team to identify member community support and provide health education as appropriate.

    Education/Experience:
    Requires a High School diploma or GED
    Requires 1 2 years of related experience

    Provides support to members to connect them to known community and care resources in a cost- effective manner

    Supports the coordination of community outreach resources available to members and promotes awareness of care/services

    Serves as support for members on community and care resource inquiries and opportunities available to members

    Supports all member related correspondence and educational materials to assist in the facilitation of a successful community connection

    Documents and maintains all community resources to ensure standards of practice and policies are in accordance with health plan requirements

    Provide assistance to the clinical team of nurses and social workers. Activities include, but are not limited to outreach, community education, informal guidance and member support

    Conduct non-clinical general health assessments in order to refer members to appropriate care/services, resolve concerns on member s behalf, and gather information for medical providers and staff working within the organization

    Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate care/services, resolve concerns on member s behalf, and gather information for medical providers in staff working within our organization

    Conduct telephonic and/or in-person outreach to locate individuals and families in the community who are hard to reach

    May make visits to individual homes and/or community organizations

    Working Knowledge of Social Determinants of Health (SDOH) barriers
    Performs other duties as assigned

    Complies with all policies and standards


    MINIMUM QUALIFICATIONS

    Education and Experience
    " Requires a High School diploma or GED
    " Requires 1 2 years of related experience

    EEO:

    Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

    =========
    Position Purpose:
    Supports community connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and supports the care team to identify member community support and provide health education as appropriate.

    Education/Experience:
    Requires a High School diploma or GED
    Requires 1 2 years of related experience

    Provides support to members to connect them to known community and care resources in a cost- effective manner

    Supports the coordination of community outreach resources available to members and promotes awareness of care/services

    Serves as support for members on community and care resource inquiries and opportunities available to members

    Supports all member related correspondence and educational materials to assist in the facilitation of a successful community connection

    Documents and maintains all community resources to ensure standards of practice and policies are in accordance with health plan requirements

    Provide assistance to the clinical team of nurses and social workers. Activities include, but are not limited to outreach, community education, informal guidance and member support

    Conduct non-clinical general health assessments in order to refer members to appropriate care/services, resolve concerns on member s behalf, and gather information for medical providers and staff working within the organization

    Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate care/services, resolve concerns on member s behalf, and gather information for medical providers in staff working within our organization

    Conduct telephonic and/or in-person outreach to locate individuals and families in the community who are hard to reach

    May make visits to individual homes and/or community organizations

    Working Knowledge of Social Determinants of Health (SDOH) barriers
    Performs other duties as assigned

    Complies with all policies and standards


    MINIMUM QUALIFICATIONS

    Education and Experience
    " Requires a High School diploma or GED
    " Requires 1 2 years of related experience
    Story Behind the Need
    • What is the purpose of this team?
    • What is driving this need? (ex. Backfill for FTE or CW, new project, business growth)
    • Describe the surrounding team (team culture, work environment, etc.) & key projects.
    • Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?
    • The purpose of our team is to reduce readmissions, potentially preventable events at the emergency room, ensure members are connected to transportation and ancillary services as needed for medical care or social needs, work with parents/providers or children with elevated blood lead levels to identify source of lead and help blood lead levels trend downward, coordinate with LPHAs for treatment of any member suspected with tuberculosis, and partner with rural medical hubs for the state s Transformation of Rural Community Health program.
    • New projects and staff fluctuations (Centene reorganization and a few people on different kinds of LOAs on the team)
    • Our team is responsible for inpatient, post discharge, and emergency department diversion outreach. We also have a dedicated team that works with non-emergency medical transportation requests. Our team also outreaches providers and parents of children with elevated blood lead levels or members with suspected tuberculosis diagnosis with the purpose of coordinating with their local public health departments and state partners. Our team also delivers high need items to pregnant/postpartum members in the community in the STL city/county area. The team works in pods. Many are cross trained across projects. The team is very communicative with one another and always willing to jump in and help their peers.
    • No upcoming hiring needs at this time
    Typical Day in the Role
    • Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
    • What are performance expectations/metrics?
    • What makes this role unique?
    • Login to phone system to take inbound calls, review non-emergency medical transportation requests (verify appointments, outreach member, review claims, etc.) and approve/deny then send back to requestor, escalate any concerns to people leader, outreach members from daily report assignments for emergency department diversion, attend required meetings/trainings
    • 20-25 calls per day (inbound/outbound), answer inbound calls within 28 seconds (with less than 3% of calls abandoned), 95% on documentation/phone audits, 30% success rate with phone calls, ensuring phone application aux codes appropriately, adhere to department policy and procedures, must have working internet (preferably high speed but at least 30 Mbps for download)
    • What makes the Community Resource Coordinator role unique is its integration of care coordination, public health, and community partnership efforts, proactively addressing medical, behavioral, social, and environmental barriers to care through initiatives that reduce preventable emergency department, support transportation and social needs, and connect members to innovative rural health resources and community-based services.

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