Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nations largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Cares mission is to provide access to quality health care for Los Angeles Countys vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Job Summary
The Transitional Care Services (TCS) Care Coordinator II is responsible for outreach to providers, facilities, and others to promote members optimal health and well-being by helping them navigate and access health services when transitioning between care settings.
This position coordinates the flow of information between the TCS Community Health Worker (CHW), member, other health plan staff, provider, and medical group and discharge facility. The position supports the coordination of member care as instructed by the Transitional Care Services (TCS) program requirements including the reinforcement of follow up provider appointments, coordination of transportation and Durable Medical Equipment (DME); linking member to Community Supports, Managed Long Term Supports and Services, Doula, health education information and other community resources to address the Social Determinants of Health (SDoH). The position is responsible to ensure the contractual and regulatory requirements and timelines are met by maintaining accurate documentation and following up with the member and provider as needed.
In addition, this position is assigned projects to support the department in meeting its regulatory and contractual requirements, such as running reports, data validation, quality checks and other projects. The position assists with the communication and coordination between programs and maintains confidentiality when communicating member information.
Duties
Responsible for the time sensitive processes for initiating cases, managing referrals to the department, appropriate documentation, routing of information, performing computer data input, faxing, emailing, filing of confidential member information, and maintaining activity logs etc. (50%)
Conducts telephonic outreach calls to discharge facilities, providers, and medical groups. Consults and collaborates with the TCS CHW to set up provider/specialist appointments and follow up. (10%)
Collaborates with team members and health plan staff to coordinate services for members. (10%)
Provides administrative assistance to ensure compliance with the TCS case tracking and closing out within the 30 day time frame. (10%)
Initiates follow up calls to Community-Based Organizations and other internal departments to confirm linkages to appropriate resources. (10%)
Performs other duties as assigned. (10%)
Duties Continued
Education Required
High School Diploma/or High School Equivalency Certificate
Education Preferred
Associates Degree
Experience
Required:
At least 6 months of experience in an administrative and/or customer service role in a health care/health services setting.
Preferred:
2 years of experience as a Medical Assistant or similar role.
1 year of experience processing authorizations at a managed care/health plan setting.
Skills
Required:
Knowledge of medical terminology.
Strong verbal and written communication skills.
Proficiency in Microsoft Office with a high level of accuracy.
Ability to work in multiple systems/databases.
Excellent organizational, and time management skills.
Detail-oriented and a team player.
Excellent customer service skills with compassion and empathy.
Ability to demonstrate sensitivity and respect for the opinions, perspectives, customs, and individual differences of others.
Ability to value diversity of people and ideas, as well as interact with people from a wide range of backgrounds.
Ability to be flexible, open-minded, listen to and consider others viewpoints.
Ability to work well and develop effective relationships with diverse personalities.
Preferred:
Bilingual in one of L.A. Care Health Plans threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese
Licenses/Certifications Required
Licenses/Certifications Preferred
Certified Medical Assistant (CMA)
Required Training
Physical Requirements
Light
Additional Information
Preferred:
Motivation Interviewing
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including