Clinical Care Coordinator in Chicago, IL at Beacon Health Options

Date Posted: 10/18/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Care Coordinator to join our remote team in Illinois.  The Care Coordinator for the Illinois programs will coordinate integrated, seamless and person-centered service in support of enrollees who are in the Medicare Medicaid alignment. Provide holistic assessment, care, and complex care planning and management services. The Care Coordinator will coordinate among all Interdisciplinary Care Team members to develop and execute the individualized care plan (ICP).

Position Responsibilities:

  • Along with the primary care provider (PCP) or behavioral health provider (BHP), serve as a team member of the Interdisciplinary Care Team (ICT) for members with primary behavioral health conditions.

  • Facilitate clinical policies implementation and maintenance, assess training and development needs for, and identify clinical resources and tools to improve program effectiveness and quality. S/He will be responsible for maintaining accurate information in Beacon’s and the Health Plan’s clinical documentation systems as directed.

  • Provide team management that demonstrates a supportive environment, clear expectations, coaching and accountability for team performance.

  • Identify, assess, and holistically manage complex behavioral health cases for those members who are in the dual eligible program.

  • Advocate for and empower member.

  • Provide individualized person-centered support to members.

  • Develop ICP for each member in coordination with all team members, adhering to timelines and including comprehensive assessment of health needs, individualized care plans, implementation, monitoring and evaluation of care outcomes.

  • Collaborate with PCP, BHPs, other members of the health care team, Health Plan Complex Care Managers, Social Care Managers, Pharmacy, and others to arrange and coordinate services for the member to help member reach their highest level of functioning and optimize the member’s ability to engage in the appropriate plan of care.

  • Coordinates necessary services with participating ancillary service providers including community based providers, peer specialists, and public agencies as appropriate to ensure quality cost effective care for the member.

  • Arrange for health care services within the scope of available benefits.

  • Collaborate with Health Plan and strategic partners in locating a primary care provider (PCP) with an open panel or locating in-network BHP.

  • Assist member with appointment and aftercare planning.

  • Document care activities and progress in Flexcare 360.

  • When delegated, oversee activities associated with member welcome and orientation. Ensure that initial member assessment and annual updates are completed and documented.

  • Support the member in all administrative aspects of the program such as benefit coverage, including pharmacy and behavioral health, eligibility guidelines and enrollment procedures, verification of eligibility, research and resolution of enrollment/eligibility issues and fulfillment of member materials (e.g., ID cards, member handbooks, etc.).

  • Assist member in understanding services that require prior authorizations or referrals and assist in procuring those authorizations/referrals.

  • Provide support to the members’ needs such as access to multilingual capabilities, access through TTY or TDD for those who are hearing impaired, assistance with locating non-emergency transportation services and information on available services within the community such as food pantries and other public assistance programs.

  • Convene needed care conferences as required in the IL contracts.

  • Work closely with the Beacon and the Health Plan’s Member Services/Customer Services, Claims, Quality and Compliance, Appeals and Grievances, and other departments to effectively respond to member needs.

  • Responsible for completing work in a timely manner.

  • Work will meet compliance requirements for state regulatory bodies, CMS, NCQA, Beacon and Health Plan (if applicable) standards.

  • Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.

  • Provide clinical direction to the Community Liaisons and their assigned activities

  • Other duties as assigned

Minimum Entry Level Qualifications

Education: Master degree related field with a valid unrestricted license

License:

Valid Unrestricted license as a LSW, LPC, LPN, RN or other master’s level behavioral health professional required.  A CADC and bachelor’s degree may also be considered.

Position Requirements:

  • At least 1-year experience with a behavioral health population in acute or community based programs, strong organization skills, and electronic record keeping. Excellent communication skills (verbal and in writing).Experience working with individuals of different cultural and ethnic backgrounds preferred. Waiver experience with Brain Injuries, Elderly, Disabled, HIV/AIDS and Supportive Living Facilities highly desirable. Bilingual bicultural experience is highly desirable. Ability to manage multiple priorities and work collaboratively within a team environment required. Managed care experience preferred.

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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