Care Coordinator (HEDIS Measures) SE WI Preferred Remote
Molina Healthcare Milwaukee, Wisconsin; Madison, Wisconsin; Port Washington, Wisconsin; West Bend, Wisconsin; Racine, Wisconsin Job ID 2029015Molina Healthcare is hiring for a Care Coordinator. This role is remote with a preference for location being in/near southeastern Wisconsin.
The (non-clinical) Care Coordinator works with members, providers and multidisciplinary team members, focusing on specific HEDIS measures- Asthma, Diabetes and Hypertension. This role will assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.
Highly Qualified Applicants will have the following qualifications-
- A passion for providing the education needed to members to help manage and improve chronic health conditions.
- Background or experience in social work, community health, Community Health Worker (CHW), public health, health education, Certified Health Education Specialist (CHES), or the like.
- Above average computers skills (able to work proficiently in MS Outlook, Word, Excel)
Job Duties
- Performs care coordination activities in collaboration with health care providers, other HCS staff, involved medical case managers, case management processors, community-based organizations (CBOs), and other providers as required to provide timely and accurate service authorizations and integrated care.
- Assist members with social determinant of health needs, challenges in accessing health & community resources or other needs that fragment care and lead to poor health outcomes.
- Documents all findings, contacts, and interventions in the electronic care management system.
- Collaborates with state agencies, healthcare professionals and community support systems promote integrated care.
- Expected to meet daily production standards in terms of member outreach.
- Provide face-to-face care coordination activities in the communities where members reside.
- Assesses for barriers to care, provides care coordination and assistance to member to address psychosocial, financial, and medical obstacle concerns.
- Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements and converting these terms to configuration parameters.
- Coordinating the authorization of needed services such as timely approval of durable medical equipment, pharmacy, and medical supplies.
- Ensuring access to Medically Necessary physical health or Behavioral Health through assisting with appointments and transportation services.
- Provides coaching/information for available health services or health education
- #LI-TR1
Job Qualifications
Required Education:
- Bachelor’s Degree in a health care related field; however, relevant experience will be considered in lieu of degree.
Required Experience:
- Para-professional whose background is anchored in social work or community health systems – per contract can be non-licensed.
- Min. 1 year clinical experience
Preferred Qualifications:
- Experience in social services, medical terminology
- Experience in managed care environment; including knowledge or applicable state and federal regulations and standards.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words: HEDIS, CHES, Certified Health Education Specialist, WI, Public Health, Health Education, Communication, Instructional Skills, Training, Member Training, Teacher, Training, Health Education, CHW, Community Health Worker, Social Work, Case Management, Non-Clinical Case Management, Case Care, Case Specialist
Pay Range: $16.4 - $31.97 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 12/07/2024ABOUT OUR LOCATION
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