Care Coordinator

Langley Health Services

We are looking for a full-time Care Coordinator who is a robust team player. We hire to retire. Join our awesome team of professionals today!
Linkedin: https://www.linkedin.com/company/langley-health-services/
PERKS:
  • health insurance (medical, dental, vision)
  • FREE medical co-pays
  • paid time off
  • eight paid holidays
  • company paid life insurance and short term disability
Primary responsibilities include but are not limited to:
  • Function as Care Coordinator/Case Manager for adult and pediatric populations
  • Learn and understand the HEDIS technical specifications for all HEDIS/Stars measures for Part C and Part D
  • Participate in monthly meetings with insurance plans to discuss compliance on HEDIS measures and receive education regarding measures
  • Coordinate, complete, and update management on all HEDIS processes and results
  • Organize and maintain a plan of action to improve HEDIS scores
  • Request and evaluate reports for member compliance and improvement opportunities for each HEDIS measure
  • Ensure compliance by conducting quality audits and maintaining all data and process controls
  • Works closely with internal and external teams to ensure high quality scores and quality rankings for providers
  • Works as part of a team to ensure consistent, timely, and appropriate completion of HEDIS/Stars measures for Part C and Part D
  • Provide education regarding HEDIS measures and Care Gaps content and respective EHR workflows to patients, providers and support staff teams
  • Communicate with providers, office staff, internal teams, health plan teams, and others involved with insurance plans and HEDIS measures to ensure high compliance ratings on measures
  • Ensure effective tracking of test results, medication management, and adherence to follow-up appointments
  • Contact patients to discuss gaps in care to be addressed and schedule appointments for this purpose
  • Document care gaps for providers and support staff so the care gap can be met during patient visit, if appropriate
  • Maintain productivity level as determined by the Director of Nursing and Operations
  • Participates in professional development activities to stay current with trends, practices and requirements for HEDIS and MRA
  • Maintain HIPAA with confidential approach to patient information at all times.
  • Collect data and produce Quality Improvement reports to participate in the Quality Improvement Committee.
  • Ensure effective and efficient communication among and between departments.
  • Collaborates with Associate Chief Operating Officer, Director of Operations, Chief Operations Officer, Chief Medical Officer and staff to facilitate and resolve patient care issues
  • Travel to other LHS locations may be required
  • May be required to provide clinical staff coverage if critical shortage exists
  • Other job duties as appropriate and assigned by supervisor
Qualifications:
  • Associate’s or Bachelor’s degree in Nursing or healthcare related field preferred; direct care experience may be substituted for degree at the discretion of management.
  • Current Florida Registered or Practical Nursing license without violations
  • Current BLS certification
  • Previous Care Coordination, Case Management or Home Health experience-preferred
  • Experience with navigation of local medical and social support systems -preferred
  • Previous experience with health systems and data reports-preferred
  • Computer proficient
  • Excellent interpersonal, communication, and organizational skills
To apply please email your resume to the reply link or fax to 855-832-3504, attention Human Resources. We are an equal opportunity employer and drug-free workplace

To apply for this job email your details to hr@telmedical.com