Job Description

Every day, we care for patients with chronic conditions in their home and in facilities. We try our best to keep them feeling well and comfortable so that they can live their lives to the fullest.

Our Care Coordination team provides critical back-office administrative support to our clinical care teams and to our patients, including, but not limited to:

·         Telephonic/Email/Other Support to Patients and Families – serving as a critical liaison for patients for clinical issues, connecting with their clinical care team, and being a first-line response for the patient experience with PopHealthCare

·         Scheduling/Rescheduling Patient Visits – assisting our clinical care teams to ensure patient visits are scheduled in a timely manner at a time that is mutually conducive for the highest quality of care

·         Order Management Facilitation and Administration – supporting the administration of timely fulfillment of required medications and services for our patients

·         Hospitalization Support – providing administrative follow-up and support for patients transferred to a higher level of care including routine check-ins with the hospital to confirm discharge status and timing

·         Clinical Care Team Assignment Management – providing support to ensure all patients are assigned to their full clinical care team for support

·         Member Notices and Letters – providing administrative support to our patients to ensure they receive timely and accurate notices and communications

·         PCP/Specialists/Other Care Team Notifications – providing support to ensure other members of the patient’s community clinical care team are aware of the care and support being provided to the patient, with an emphasis on driving coordination across all of the members of the patient’s community clinical care team

·         MTM/Pharmacy Support – supporting the completion of MTM reviews for patients including providing administrative support and liaison between the PHC provider and the pharmacist

The Care Coordination Manager manages has overall responsibility for the management of the Care Coordination team. As a manager, the person will be responsible to build, train and maintain a team of Care Coordinators who strive to provide the best support possible to the clinical teams in the markets which in turn enables members to get the best health possible. This position will be responsible for managing Care Coordination team workload, ensuring timeliness and productivity metrics are maintained, and identifying opportunities to streamline and continuously improve administrative and operational processes.

POSITION ESSENTIAL FUNCTIONS:

•               Supervises the daily operations of staff in assigned Care Coordination teams and reports any operational issues.

•               Ensures compliance with established regulations, criteria, guidelines, protocol, and policies and procedures as they affect or relate to Care Coordination programs.

•               Assures optimum productivity levels of staff and utilization of services by managing budget within staffing model guidelines.

•               Evaluate existing call center processes for best practices and implement continuous improvements, in term of efficiency of support processes, customer satisfaction, metrics, goal standards, and application of tools for monitoring, management, and optimization.

•               Interfaces with both internal and external clients, customers and vendors. 

•               Proactively partners with other departments to provide information and feedback, analyze reports for continuous improvement and resolve customer/client issues

•               Reviews data, specifically as it relates to the functions of the Care Coordination function, to monitor activities related to performance standards.

•               Reports to management any issues related to an individual staff member’s job performance that may urgently impact the ability to fulfill contract requirements;

•               Assist in program implementation and program changes.

•               Assist with program audits and chart reviews.

•               Completes quarterly reports, activity reports, and performance summaries for staff;

•               Performs Care Coordination activities as required by the program and budgetary needs.

•               Foster a team environment, including providing coverage as needed for other members of the team.

•               Recommends changes or improvements based to streamline and continuously improve administrative and operational processes;

•               Ability to manage, prioritize, and execute multiple tasks on time in a fast-changing environment.

•               Maintains confidentiality of all client protected health information and adheres to all HIPAA related policies and procedures.

•               Ability to work independently and make decision while adhering to company standards and guideline.

Qualifications

POSITION REQUIREMENTS:

•               Bachelor’s degree required and/or equivalent work experience in a management position, health care setting

•               Excellent analytic and presentation skills.

•               Proficient in Microsoft Word, Excel, PowerPoint, Sharepoint and other Microsoft Office products.

•               RN degree preferred

•               Minimal of 3 years of leadership/management experience required of managing medium to large teams

•               Experience working in a clinical setting or medical office as an office manager or care coordinator preferred

•               Minimal of 2 years call center leadership experience preferred

•               Experience in a position demonstrating exceptional written, verbal, and interpersonal communication

•               Strategic leadership skills and business acumen to execute initiatives and objectives.

•               Problem solving—the individual identifies and resolves problems in a timely manner and gather and analyze information skillfully

•               Planning/organizing—the individual prioritizes and plans work activities, uses time efficiently and develops realistic action plans

•               Excellent communication and interpersonal skills with ability to communicate across all levels of the organization, including technology, tools, and processes

•               Ability to travel occasionally as required for the job

Additional Information

POPHEALTHCARE IS AN EQUAL OPPORTUNITY/EQUAL ACCESS EMPLOYER FULLY COMMITTED TO ACHIEVING A DIVERSE WORKFORCE.

Job Type: Full-time