Clinical Care Coordinator

The Panther Group

Boston, MA

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JOB DETAILS

LOCATION

Boston, MA

POSTED

30+ days ago

Position Summary
The Clinical Care Coordinator is a licensed Registered Nurse (RN) OR Licensed Clinical Social Worker (LCSW) responsible for the delivery and oversight of care coordination functions across behavioral and physical health domains. This role is a critical by supporting and delivering exceptional quality-driven, member-focused services.

Key Responsibilities
Care Coordination Support
   Deliver coordinated services to all members, including those with complex medical, behavioral health, and developmental needs.
   Collaborate with the TPA regarding care coordination workflows, transitions of care, and high-risk member support.
   Monitor key health indicators and recommend interventions to reduce avoidable emergency visits, hospitalizations, and readmissions.
Reporting Support
   Preparation and submission of Clinical Data Requirements List (CDRL)
   Coordinate with analysts and the TPA to verify data accuracy and completeness.
   Support reporting analysis to inform clinical care strategies and program improvements.
   Contribute to audit preparation and support compliance with documentation standards.

Clinical Quality & Performance Improvement
   Monitor clinical quality measures such as HEDIS and other TRICARE standards.
   Collaborate with internal teams to support and implement care interventions aligned with quality goals.
   Evaluate care plans, adjust as needed, and track member progress toward improved outcomes.
   Recommend process improvements to enhance clinical operations and care efficiency.

Member & Provider Interaction
   Guide members through the healthcare system with a focus on advocacy, cost-effective resource utilization, and person-centered care.
   Educate members and providers on TRICARE benefits, community-based resources, and support programs.
   Facilitate effective transitions of care and ensure timely, coordinated service delivery across providers and systems of care.

Administrative Support
   Support operational planning and team goals.
   Contribute to development of policies and procedures in alignment with contract expectations.
   Perform additional tasks to support the department and ensure timely service delivery

Qualifications
Education & Experience
   Minimum 3-5 years of care coordination or case management experience.
   Familiarity with TRICARE, ECHO, ACD, and DHA/DoD health system standards preferred.
Licensure & Certifications
   Active RN license or LCSW in the state of Massachusetts, Connecticut, New Hampshire or Rhode Island.
Skills & Competencies
   Strong documentation, organizational, collaboration and communication skills.
   Critical thinking and problem-solving skills.
   Proficiency in EMR systems, reporting tools, and regulatory documentation.

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About the Company

The Panther Group

The Panther Group is minority owned and certified, making diversity, equity and inclusion core components of our mission.

With our commitment to respecting and empowering our employees as individuals, diversity is a competitive advantage in the marketplace.

The Panther Group has a proven track record of connecting quality talent with the right position. We believe in a hands-on approach, with a focus on building lasting relationships with our Employees and our Clients. Our Employees find flexibility and growth to reach their career goals.

The Panther Group celebrates 25 years of recruitment and workforce solutions expertise.

COMPANY SIZE

20 to 49 employees

INDUSTRY

Staffing/Employment Agencies

FOUNDED

1992

WEBSITE

http://thepanthergrp.com

Clinical Care Coordinator

The Panther Group

Boston, MA

About the Company

The Panther Group

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