Job Description
We are seeking experienced Clinical Care Coordinators (Licensed Registered Nurses) to join a healthcare team based in the District of Columbia. This is primarily a remote position with occasional face-to-face visits required.
Responsibilities:
Manage a caseload as directed by Care Management leadership, ensuring timely and effective follow-up with enrollees.
Connect with enrollees at predetermined intervals, and more often as needed based on their stratification level.
Conduct in-person visits, as needed, with enrollees and their caregivers in their homes, physician offices, or mutually agreed upon locations.
Assess enrollees at the time of enrollment and at intervals to identify needs, barriers, and opportunities for closing care gaps.
Perform routine care coordination and management activities, ensuring compliance with national standards and company policies.
Collaborate with Senior Care Managers to prioritize cases, set objectives, and address any risk and utilization concerns.
Consult with designated experts in specialty areas when necessary.
Document all findings and interactions in a timely and accurate manner, in line with organizational policy.
Maintain confidentiality of enrollee information in accordance with company policies.
Contribute to discharge planning and work closely with enrollees, families, and providers to coordinate care transitions.
Help enrollees and caregivers understand the importance of preventive services, striving to meet target compliance rates for medical and dental services.
Provide education and resources related to medication administration, conditions, self-management techniques, and assistive technology use.
Guide enrollees through transitions of care, such as from pediatric to adult care providers, or when transitioning between outpatient and inpatient care.
Facilitate the authorization process for services requiring Care Management approval.
Use effective communication skills to ensure understanding and collaboration with enrollees, caregivers, providers, and team members.
Maintain a professional, customer-focused demeanor in all interactions.
Demonstrate proficiency with medical terminology and the healthcare delivery system.
Organize and manage time effectively to meet deadlines while maintaining high-quality customer service.
Qualifications:
3-5 years of experience in managed care and/or care management.
3-5 years of experience in clinical or community resource settings.
Strong verbal and written communication skills.
Bilingual (Spanish-speaking) preferred.
Familiarity with medical terminology.
Proficiency with computer systems, including Microsoft Office Suite.
Strong organizational skills and the ability to prioritize effectively.
Sound decision-making skills and the ability to apply good judgment.
Ability to work under pressure while maintaining a positive attitude.
Experience participating in professional meetings, both internal and external.
Licenses/Certifications:
Licensed as a Social Worker (LICSW) or Registered Nurse (RN) in the District of Columbia.
Certification as a Case Manager is preferred.
Education:
Associate's degree required; Bachelor's degree preferred.
Additional Information:
Moderate mental and visual stress involved, with periods spent using a PC keyboard and monitor.
Occasional weekend, evening, or early hours required to meet member needs.
We are committed to building a diverse workforce and encourage applicants from all backgrounds to apply. We provide equal opportunities in employment and do not discriminate based on race, color, religion, gender, sexual orientation, gender identity, or any other characteristic protected by law.
Employment Type: Full-Time
Salary: $ 43.00 Per Hour
Job Tags
Hourly pay, Full time, Home office, Afternoon shift,