SCO Care Coordinator # 26-18398

1. Support the General Care Management Process within the Care Management Department (35%) Initiate requests for clinical information from inpatient providers within department timelines. 3. Serve as Central Contact for Nurse Practitioners (HMO/SCO) (20%) Contact members to schedule Nurse Practitioner (NP) assessments using Language Line services when necessary.

Duration: 3+ months contract (with possible extension)

Job Description: 
1. Support the General Care Management Process within the Care Management Department (35%)

• Initiate requests for clinical information from inpatient providers within department timelines.
• Accurately identify when to escalate issues that may prevent meeting department timelines for:
  • Provider denial notifications.
  • Requests for additional clinical information.
• Track and manage member notifications within the defined intervention period.
• Complete follow-up responsibilities within required timeframes.
• Generate and distribute educational and coaching materials to members, families, and caregivers regarding:
  • Follow-up care.
  • Health status.
  • Transition care goals.
  • Health insurance benefits.
  • Self-management of care.
• Generate multiple daily Individual Plans of Care (IPC) for SCO members for timely mailing and distribution.
• Review and participate in daily reporting of care management services and process outcomes.
• Assist with the execution of special projects and outreach campaigns.

2. Perform General Office Duties (25%)

• Generate daily census reports for Care Management.
• Sort departmental mail.
• Scan and file returned mail.
• Fax, photocopy, and file documents.
• Research member addresses and contact information when preparing mailing labels and envelopes.
• Maintain adequate inventory of Disease Management educational materials.
• Effectively multitask when handling multiple deliverables.
• Manage copy requests by:
  • Separating Copy Center requests from routine copy jobs.
  • Completing and submitting Copy Center request forms.
  • Following up on urgent copy requests.
  • Copying and distributing smaller requests.
  • Organizing documents into binders or preparing them for mailings.

3. Serve as Central Contact for Nurse Practitioners (HMO/SCO) (20%)

• Contact members to schedule Nurse Practitioner (NP) assessments using Language Line services when necessary.
• Schedule translation services for in-home NP visits.
• Maintain NP assignment calendars and communicate updates according to policy.
• Identify and escalate issues to the Team Leader when appropriate.

4. Departmental Process Support (15%)

• Provide process support for duties unique to the assigned service operations area.

5. Meetings and Training (5%)

• Attend scheduled meetings.
• Participate in assigned training sessions.

Education

• High School diploma or equivalent (required).
• Associate degree in Business or completion of a Medical Assistant, Medical Technology, or LPN program (highly desirable).

Experience

• 3–5 years of experience in a professional work environment (required).
• Experience in a healthcare environment, particularly managed care (highly desirable).
• Internal applicants should have experience with:
  • CCMS
  • MedHok
  • CaseTrakker
  • Diamond
  • Macess
• External applicants must demonstrate the ability to become proficient in these systems within three months of training.

Skills & Competencies

• Proficient in:
  • Microsoft Word
  • Microsoft Excel
  • Email applications
  • Intranet systems
• Experience with the following is preferred:
  • Microsoft PowerPoint
  • Microsoft Access
  • Microsoft Visio
  • Other software applications
• Ability to:
  • Work independently and collaboratively across multiple organizational levels.
  • Deliver excellent customer service.
  • Communicate effectively, both verbally and in writing.
  • Recognize emergency situations and follow established protocols.
  • Manage multiple priorities while adhering to established procedures.
  • Demonstrate strong organizational and time management skills.
  • Adapt to increased workloads and flexible coverage responsibilities.
  • Understand Clinical Services departments and organizational processes.
  • Maintain a professional and mature demeanor.
  • Exercise sound judgment and decision-making.
  • Handle confidential information in accordance with corporate compliance policies.

Notes:

• Preferred someone from New England states (MA, NH, CT, RI, VT)

About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visitwww.ustechsolutions.com.

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring.

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