Special Needs Coordinator
About the position
Responsibilities
• Coordinate care for highly complex members as part of an inter-disciplinary care team approach
• Consult and collaborate with local health departments, primary care providers, Federally Qualified Health Centers (FQHCs), social service agencies, and specialty care services to address member complex care needs
• Manage referrals to the REM (Rare and Expensive Medical special needs care management) program, including outreach, education, and coordination of member transfer
• Serve as a liaison with the MDH REM office
• Ensure appropriate re-direct for members to in-network specialty services, working closely with the Prior Authorization team
• Act as a Housing coordinator, requiring understanding of county-based resources
• Educate Local Health Departments and Community Advisory Committee attendees about Plan programs and services
• Represent Special Needs Members at Plan's Quarterly Consumer Advisory Board
Requirements
• Current unrestricted nursing license (e.g., LPN, LVN) OR Bachelor's level Social Worker (licensed or non-licensed) with work experience in a health care setting
• 3+ years of experience in a clinical or managed care setting
• Experience with care coordination or case management
• Experience with arranging community resources
• Experience providing clinical care to low-income populations
• Understanding of Medicaid member needs and benefits
• Computer/typing proficiency to enter/retrieve data in electronic clinical records and documentation systems; experience with email, internet research, use of online calendars and other software applications
• Proficient with Excel to create and pull reports
Nice-to-haves
• 5+ years of experience in a clinical or managed care setting
• Experience and comfortability collaborating with providers and State partners
• Experience with EMR [Electronic Medical Records] and care management platforms including the State Health Information Exchange [CRISP]
• Proven ability to think creatively and work comfortably within a hands-on, fast-paced, high-demand environment
• Proven ability to work with diverse care teams in a variety of settings
• Proven ability to exhibit independent clinical judgment, but the ability to consult and engage with other team members for improved patient outcomes
• Proven excellent administrative, organizational and verbal skills
• Proven effective time management and prioritization skills for competing demands
• Proven comfort with ambiguity, willingness to adjust as demands change and evolve
Benefits
• Flexible remote work options
• Opportunities for professional development
• Recognition for performance
• Supportive work environment that encourages growth
Apply Now
Apply Now
Responsibilities
• Coordinate care for highly complex members as part of an inter-disciplinary care team approach
• Consult and collaborate with local health departments, primary care providers, Federally Qualified Health Centers (FQHCs), social service agencies, and specialty care services to address member complex care needs
• Manage referrals to the REM (Rare and Expensive Medical special needs care management) program, including outreach, education, and coordination of member transfer
• Serve as a liaison with the MDH REM office
• Ensure appropriate re-direct for members to in-network specialty services, working closely with the Prior Authorization team
• Act as a Housing coordinator, requiring understanding of county-based resources
• Educate Local Health Departments and Community Advisory Committee attendees about Plan programs and services
• Represent Special Needs Members at Plan's Quarterly Consumer Advisory Board
Requirements
• Current unrestricted nursing license (e.g., LPN, LVN) OR Bachelor's level Social Worker (licensed or non-licensed) with work experience in a health care setting
• 3+ years of experience in a clinical or managed care setting
• Experience with care coordination or case management
• Experience with arranging community resources
• Experience providing clinical care to low-income populations
• Understanding of Medicaid member needs and benefits
• Computer/typing proficiency to enter/retrieve data in electronic clinical records and documentation systems; experience with email, internet research, use of online calendars and other software applications
• Proficient with Excel to create and pull reports
Nice-to-haves
• 5+ years of experience in a clinical or managed care setting
• Experience and comfortability collaborating with providers and State partners
• Experience with EMR [Electronic Medical Records] and care management platforms including the State Health Information Exchange [CRISP]
• Proven ability to think creatively and work comfortably within a hands-on, fast-paced, high-demand environment
• Proven ability to work with diverse care teams in a variety of settings
• Proven ability to exhibit independent clinical judgment, but the ability to consult and engage with other team members for improved patient outcomes
• Proven excellent administrative, organizational and verbal skills
• Proven effective time management and prioritization skills for competing demands
• Proven comfort with ambiguity, willingness to adjust as demands change and evolve
Benefits
• Flexible remote work options
• Opportunities for professional development
• Recognition for performance
• Supportive work environment that encourages growth
Apply Now
Apply Now