CLINICAL SERVICES CARE COORD in Miami, FL at Beacon Health Options

Date Posted: 10/21/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Care Coordinator to join our team at our office in Miami, FL.  The Care Coordinator is responsible for overseeing and coordinating the integrated follow up for members who have been identified as having a co-existing medical and behavioral health disorder or are deemed high risk members. Provides close monitoring and follow up for these members and communicates with the health plan, treating practitioners, and/or referral source for evidence of coordination of care.  Communication of information may be telephonic or onsite at provider facilities, community based treatment centers, etc.

Position Responsibilities:

  • Oversee Inpatient member discharge plans.

  • Act as liaison between hospital staff and the member’s family/support system/providers.

  • Coordinate Outpatient care for members without a discharge plan, link members and their families to appropriate community supports and Outpatient treatment.

  • Coordinate and oversee Outpatient referrals for integrated medical/behavioral health services to network practitioners based on practitioner specialty and member’s geographic, cultural and language preferences.

  • Collaborate with Inpatient and Outpatient Case Managers in identifying and removing barriers to member compliance with Outpatient care.

  • Coordinate urgent Outpatient referrals.

  • Track communication and correspondence for all members on caseload and maintain monthly reports on case disposition.

  • Responsible for monitoring and reporting compliance with Aftercare appointments for all members identified as having been admitted for Mental Health / Substance Abuse treatment.

  • Maintains detailed records of members who have been admitted to Inpatient treatment from the point of discharge for up to 30 days post-discharge to monitor compliance with 7 and/or 30 day ambulatory follow up.

  • Responsible for generating authorizations for facility-based, post-discharge follow up visits and maintaining accurate files for ambulatory follow-up notes submitted as evidence of a post-discharge visit.

  • Inputs all member data/information obtained in the course of coordinating care into the Case Management System.

  • Maintains open lines of communication with health plan contacts to ensure coordination of care.

  • Participates, as appropriate, in case rounds with the health plan contacts to discuss complex cases.

  • Participate in case rounds with the health plan contacts to discuss complex cases.

  • Plays a vital role in identifying trends, deficiencies, and/or barriers related to ambulatory follow up so that appropriate interventions can be designed to improve overall compliance rate.

  • 15% local travel

Position Requirements:

Education:  Bachelor’s level preferred; Certified Wellness Coach recommended plus a fundamental knowledgebase of Managed Care benefits. 

Generic Skills: General computer and customer service skills and experience, plus a fundamental knowledgebase of Managed Care benefits.  Written and Verbal English Proficiency required.

Relevant Work Experience:  

“Requires at least 10 years of progressively responsible professional experience in healthcare, with at least five (5) of those years in behavioral health.”)

Customer Service experience required; Therapeutic / Care Coordination experience preferred; and a      fundamental knowledgebase of Managed Care benefits. 

Knowledge, Skills & Abilities:

  • Excellent computer skills

  • Strong analytical and problem solving skills

  • Strong written and verbal communication skills

  • Detail oriented and able to work independently

  • Supervisory experience

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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