Highmark Health Care Coordinator Arkansas in Little Rock, Arkansas

Description

This is a work from home position in Arkansas, candidates must be located in Arkansas to be considered

JOB SUMMARY

This job functions as the Care Coordinator for the Arkansas PASSE (Forevercare) line of business and serves as a liaison and mediator between members, providers, community centers, and the Organization. Works independently in the community engaging members within a specific target population as defined by the Plan. Works face-to-face with members to provide care coordination support, basic health literacy, linkage to community resources, and assistance navigating the healthcare system. Provides members with education and information consistent with member’s care plans developed by their healthcare providers or other points of service, and serves as a healthcare advocate for the member. The goal is to outreach and engage members to improve health outcomes, close care gaps and improve overall wellness by connecting members to providers and community resources and develop partnerships with community centers and local community based resources to support the needs of the members as well as the community. The incumbent works closely with the care management department to refer members for additional support and education beyond the job's scope of practice.

ESSENTIAL RESPONSIBILITIES

  • Initiate outreach efforts, face-to-face, to support care coordination efforts and to support healthcare coordination, such as but not exclusive of targeted preventive health, maternity, care transitions and chronic condition initiatives.

  • Educate member(s) on the importance of targeted preventive health services, assess opportunity for care coordination support, make appropriate referrals, including referrals to healthcare services to support the member’s need, such as, but not exclusive of, physical health, behavioral health, developmental or habilitation support.

  • Contact member(s), providers and community agencies to coordinate access to preventive health services.

  • Develop a rapport with members and community centers to establish a supportive relationship which empowers members to take an active role in their health and wellness.

  • Assist members with completing a Health Risk Assessment, identifies/providing direction to managing healthcare barriers (i.e. knowledge deficit, transportation, financial), scheduling appointments, and answering questions.

  • Collaborate with human services providers such as, but not exclusive of, Head Start Programs, WIC, community centers, and homeless shelters; as well as state agencies such as Children and Youth Services (CYS) and probation services in the identification and outreach to members in need of services.

  • Understand the benefits the Plan is able to cover for members in order to provide accurate and current information to member in the community.

  • Contribute to the development and preparation of educational materials for members and providers.

  • Conduct provider and community training on Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services and other special preventive health initiatives.

  • Provide summary and outcomes of training to management and peers.

  • Participate in the development of programs that are effective, measurable and innovative, with a special emphasis on reaching at risk members.

  • Represent the company at community events, including events sponsored by community centers.

  • Other duties as assigned or requested.

EDUCATION

Required

  • High School Diploma/GED

Substitutions

  • None

Preferred

  • Bachelor’s Degree

EXPERIENCE

Required

  • 1 year working with developmentally or intellectually disabled clients or behavioral health clients

Preferred

  • Experience in a health care related customer service or marketing environment that would demonstrate the ability to positively impact the engagement of members in the organization's condition and case management programs

  • Bilingual, Spanish speaking

  • Basic medical terminology background

  • Experience with the targeted community or population

LICENSES AND CERTIFICATIONS

Required

  • N/A

Preferred

  • None

SKILLS

  • Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services

  • The ability to interact well with peers, supervisors and customers and work as a team member

  • Ability to solve problems independently and creatively and be proactive, self-directed, assertive and creative in problem solving and system planning

  • Ability to handle many tasks simultaneously and respond to customers and their issues promptly

  • Possess good written and oral communication skills

  • Have an appreciation of cultural diversity and sensitivity towards the Medicaid population with demonstrated expertise in topics related to cultural competency including working with members with limited English proficiency. Be aware of issues members face related to healthcare including transportation, child care, lack of knowledge concerning preventive health, distrust of the system as well as other personal, social, financial barriers

  • Must demonstrate patience and empathy when interacting with members and all internal/external customers

Languages (Other than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Primarily on-the-road, with some office-based, including co-location at provider offices

Teaches/Trains others regularly

Rarely

Travels regularly from the office to various work sites or from site-to-site

Frequently

Works primarily out-of-the office selling products/services (Sales employees)

Does Not Apply

Physical Work Site Required

No

Lifting: up to 10 pounds

Frequently

Lifting: 10 to 25 pounds

Never

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of

business conduct and company policies.

Unusual Working Conditions

This position will typically not work within corporate headquarters. The position could include working within a physician practice setting, visiting physician practices monthly, working within a hospital setting and/or assessing and coordinating member’s care within the member’s home. The position is a dynamic one which will require flexibility in work settings and travel.

REQNUMBER: J121106

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled