Job Description
Duration: 6 months
Compensation: $20.81 - $29.71 per hour
Description: The Personal Care Coordinator (PCC) will support the members in completing their health risk assessment (HRA). The incumbent will ensure communication of the member's HRA and care plan with the member, Primary Care Provider (PCP) and health care team. The incumbent will identify barriers to member's care and assist in improving these barriers for all levels of care. The incumbent will work closely with the PCP and health care team to ensure member access to timely services and coordination of care.
What You Will Do:
- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
- Performs outreach to members to coordinate completion of the initial and annual HRA, conducts telephonic and/or in-person HRAs as necessary and ensures data entry of HRAs received via email.
- Interviews members to determine strengths, problems, functional status, goals and need for specific services/resources.
- Maintains documentation of member's case, care plan, interventions, and interdisciplinary care team within the organizations medical management system.
- Collaborates with PCP and health care team to ensure timely communication of member's clinical information.
- Partners with licensed professionals in the development of an initial care plan for each member, incorporating the HRA and all assessment findings.
- Facilitates communication of initial care plan to the PCP and member, as necessary.
- Identifies the need for, and facilitates, referrals to Long Term Support Services (LTSS), Behavioral Health and community resources.
- Oversees warm transfers to member's assigned Case Manager in accordance with member needs, when appropriate.
- Works with Case Management staff to expedite the resolution of member concerns.
- Guides members in understanding and accessing the benefits they are entitled to under Medi-Cal.
- Notifies member's care team of key event triggers.
- Maintains compliance with established departmental productivity guidelines.
- Ensures reporting of productivity metrics to supervisor as required.
- Completes other projects and duties as assigned.
You Will Be Successful If:
- Possess the Ability to:
- Maintain accurate records and documentation.
- Contribute to the development of a plan based on assessment of the member's physical, psychosocial, functional, strengths/barriers and mental health needs.
- Establish and maintain effective working relationships with CalOptima Health's leadership and staff.
- Communicate clearly and concisely, both orally and in writing with individuals from a diverse population.
- Utilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
- Have Knowledge of:
- Principles and practices of health care service delivery and managed care, Medi-Cal, and organization eligibility and benefits.
- Long-term services and support.
- Issues that face members with special needs, such as seniors and persons with disabilities.
- Principles and techniques to serve the SPD population in diverse social and ethnic groups
- Bachelor's degree in Healthcare Management or related field preferred, High school diploma or equivalent required
- 1+ year of experience working with seniors or persons with disabilities in a customer or member services capacity
- Bilingual in Spanish is required
- 1+ year of experience in a HMO, Medi-Cal, or health services environment
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.
That's Impresiv!