CF Outsourcing Solution is dedicated to providing patients with comprehensive and integratedhealthcare services, with a special focus on behavioral health. Our organization is committed todelivering accessible, patient-centered care across multiple convenient locations. We strive toimprove health outcomes through innovative care coordination, compassionate service, and acollaborative approach to healthcare delivery.Position SummaryCF Outsourcing Solution is seeking a dedicated and detail-oriented Chronic Care Management(CCM) Specialist to support patients living with chronic medical and behavioral healthconditions. The CCM Specialist plays a critical role in improving patient outcomes throughproactive care coordination, patient engagement, education, and ongoing management ofindividualized care plans.The ideal candidate will possess experience in healthcare delivery, care coordination, casemanagement, medical documentation, and chronic disease management. This role requiresstrong communication skills, clinical knowledge, and the ability to build meaningful relationshipswith patients while ensuring compliance with healthcare regulations and quality standards.Essential FunctionsPatient Care Coordination Develop, implement, and maintain individualized patient-centered care plans using CCMsoftware. Conduct patient outreach and maintain regular contact to monitor health status,coordinate care, and provide ongoing support. Assist patients in understanding and managing chronic medical and behavioral healthconditions. Coordinate healthcare services and referrals to ensure continuity of care. Identify barriers to treatment adherence and collaborate with patients and providers toaddress care gaps. Communicate urgent or life-threatening concerns promptly to Psychiatric Clinicians/PainManagement Providers and appropriate healthcare providers.Care Management & Clinical Support Manage a caseload of up to 500 enrolled members. Conduct patient intake assessments and evaluate healthcare needs. Coordinate discharge planning and post-acute care services when appropriate. Review patient charts, medications, treatment plans, and referrals to supportcomprehensive care management. Collaborate with providers, social workers, behavioral health professionals, and otherinterdisciplinary team members to optimize patient outcomes. Coordinate with scheduling teams to ensure patients attend required appointments andfollow-up visits.Documentation & Compliance Accurately document all patient interactions, care management activities, and treatmentprogress within electronic health record systems. Maintain detailed and timely records in accordance with organizational policies andHIPAA regulations. Ensure accurate use of medical terminology, CPT coding, ICD-9, and ICD-10 coding fordocumentation and billing purposes. Monitor member eligibility and qualify patients for monthly CCM billing requirements. Add eligible members to billing systems and ensure documentation supportsreimbursement standards. Maintain confidentiality and compliance with all federal, state, and organizationalhealthcare regulations.Patient Engagement & Education Educate patients regarding their conditions, medications, treatment plans, and availablehealthcare resources. Promote active participation in care management programs and encourage adherenceto treatment recommendations. Build trusting relationships with patients through compassionate communication andpatient-centered service. Address patient concerns and provide solutions that support positive healthcareoutcomes.Duties and Responsibilities Coordinate and monitor ongoing care for patients with chronic conditions. Develop and update individualized care plans. Manage referrals and facilitate communication between healthcare providers. Review medications and treatment plans as needed. Conduct patient assessments and follow-up activities. Support discharge planning and transitions of care. Maintain accurate medical records and documentation. Ensure timely completion of required CCM activities. Meet productivity and quality standards established by CF Outsourcing Solution.Knowledge, Skills, and Abilities Strong oral, written, and telephone communication skills. Excellent organizational, multitasking, and time management abilities. Knowledge of clinical practices, chronic disease management, diagnostic procedures,and treatment protocols. Understanding of CPT, ICD-9, ICD-10 coding, and medical terminology. Strong clinical judgment, critical thinking, and problem-solving skills. Ability to work independently and collaboratively in a fast-paced healthcare environment. Exceptional customer service and patient engagement skills. Ability to build and maintain professional relationships with patients, providers, andpartner organizations. Results-driven mindset with a focus on quality outcomes and productivity.QualificationsRequired Qualifications High school diploma or equivalent required. Minimum of one (1) year of experience in healthcare, care coordination, casemanagement, chronic care management, or related healthcare roles. Experience working with electronic medical records (EMR/EHR) systems. Knowledge of HIPAA regulations and patient confidentiality requirements. Strong computer proficiency and documentation skills.Preferred Qualifications Associate's or Bachelor's degree in Healthcare Administration, Nursing, Social Work,Public Health, or a related field. Experience working in hospital, acute care, behavioral health, or outpatient healthcaresettings. Familiarity with Chronic Care Management (CCM), Remote Patient Monitoring (RPM), orvalue-based care programs. Knowledge of discharge planning, care transitions, and behavioral health integration. Bilingual abilities are a plus.Must be able to pass a drug and background check.
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