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CareOregon

Making health care work for everyone.

Health Care Coordinator

TherapistTherapistFull TimeRemoteMid LevelTeam 501-1,000Since 1994H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

71 days ago

Salary

$25 - $31 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Health Care Coordinator

CareOregon

Role Description The Health Care Coordinator (HCC) serves as a key entry point to CareOregon’s Regional Care Teams and provides comprehensive care coordination. Responsibilities include intake, navigation of physical and behavioral health benefits, and development of individualized care plans based on member needs. The HCC collaborates closely with members, providers, and external partners to ensure timely access to services, continuity of care, and improved member outcomes. Estimated Hiring Range: $25.42 - $31.07 Bonus Target: Bonus - SIP Target, 5% Annual Qualifications - Minimum 3 years’ experience working in a healthcare setting, outpatient primary care clinic, hospital, or health insurance plan - Preferred: Licensed practical nurse (LPN), certified medical assistant (CMA), certified nurse’s assistant (CNA), or Traditional Health Care Worker (THW) certification - Experience working directly or telephonically with populations utilizing OHP - Experience working with populations impacted by mental health and/or addictions - Experience working with insurance plans and/or interviewing patients or members about their health information - Experience working in Epic Requirements - Serve as the first point of contact within the Care Coordination Team for members or providers who call CareOregon requesting assistance with physical and behavioral health needs. - Coordinate referrals from members, providers, community partners, and internal CareOregon departments and teams. - Provide call escalation support for Customer Service Representatives when necessary. - Determine navigation, care coordination and/or resource needs in response to referrals and other types of calls into the Regional Care Team (RCT) phone lines. - Identify members in crisis, triage needs requiring urgent attention, and help de-escalate high-need callers. - Triage appropriate referrals and help determine care coordinator assignment for RCT clinical care coordinators based on identified member needs. - Provide telephonic-based physical and behavioral health care coordination to eligible members and families. - Maintain a caseload of members with ongoing physical and behavioral health care coordination needs. - Facilitate access and remove barriers to necessary care and services for members and families. - Facilitate communication among members, their support systems, clinical care providers, community partners, and internal CareOregon departments. - Coordinate effectively with interdisciplinary teams for integrated care plan support of complex member needs. - Provide appropriate support to clinical Care Coordination staff involved with members. - Assist members in establishing and engaging with providers. - Refer members to appropriate agencies for community support. - Coordinate care for members residing outside of service area as required in contract. - Coordinate care for members discharging from the state hospital. - Assist in transition and discharge planning for members moving from acute care, long-term care, or other residential facilities back to community-based supports. - Take independent actions to address each member’s identified needs. - Assess for and identify physical and behavioral health care coordination needs. - Identify and appropriately address risk factors and service needs that may impact member outcomes. - Utilize a trauma-informed approach to provide member-centric physical and behavioral health care and support. - Assist members in moving through the continuum of care based on clinical, medical, and behavioral health needs. - Use motivational interviewing to coach members toward improved physical and behavioral health care behaviors and self-management. - Utilize assessment information to develop individualized care plans for assigned members. - Coordinate with providers to ensure integrated physical and behavioral health care plans are timely, effective, and consider the members’ unique needs. - Implement physical and behavioral health care coordination plans in collaboration with the member, providers, case workers and other relevant parties. - Develop working partnerships with community health care providers concerning member needs and care plans. - Maintain compliance with Coordinated Care Organization (CCO) requirements. - Complete initial and subsequent documentation for care coordination activities. - Maintain working knowledge of CareOregon Advantage (COA) and Oregon Health Plan (OHP) benefits. - Report member complaints to Appeals and Grievance team for investigation and follow-up. - Assist Quality Assurance (QA) staff in identifying behavioral health providers whose practice patterns do not conform to best practice standards. - Maintain compliance with the Model of Care requirements, if applicable. - Participate in quality and organizational process improvement activities and teams when requested. - Participate in work-related continuing education when offered or directed. Benefits - Competitive pay - Bonus opportunity - Comprehensive benefits package including medical, dental, vision, life, AD&D, and disability insurance - Health savings account, flexible spending account(s), lifestyle spending account - Employee assistance program, wellness program, discounts, and multiple supplemental benefits - Strong retirement plan with employer contributions - PTO and Paid State Sick Time based on hours worked/scheduled hours - Paid holidays, volunteer time, jury duty, bereavement leave, and more Company Description CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

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