Care Coordinator for Medicare Long Term Services and Support Transition

Job Name: Care Coordinator for Medicare Long Term Services and Support Transition
Name of the Company: AmeriHealth Caritas
Location: Detroit, MI, Southfield, MI
Salary range: Salary unspecified

Position Description

AmeriHealth Caritas is seeking an experienced Care Coordinator for Medicare Long Term Services and Support Transition in Detroit and Southfield, Michigan. As a mission-driven organization with over 30 years of experience, we aim to provide comprehensive integrated care to those who need it most. Our values reside in providing services to help Americans get care, stay healthy, and build healthy communities. Our company has a longstanding history of providing customer-centric and evidence-based healthcare solutions.

The Care Coordinator is responsible for managing, implementing, and evaluating transitional care interventions for complex patients that are prone to experiencing poor health outcomes. The Care Coordinator will assess patient’s transitional needs and ensure the provision of suitable long-term services and supports, physical health, behavioral health, and necessary Social Services. This position will work as part of the Integrated Care Team under the supervision of the Medicare Long-Term Services and Support Operations Supervisor.

Responsibilities

● Perform telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member s needs.
● Identify patient/family educational needs.
● Analyze physical and psychosocial assessment data.
● Collaborate with physicians, social workers, integrated care team members, and other healthcare disciplines.
● Use effective resources and home and community-based waiver services to maximize the healthcare benefits of the member.
● Facilitate post-discharge medical and community referral services.
● Identify, track, and analyze 30-day readmissions to address system-wide improvements.
● Participate in clinical performance improvement activities to achieve programmatic goals.
● Develop routine reports materials and deliver presentations/reports to internal and external stakeholders.
● Travel throughout the service areas as required to perform duties and assignments.
● Work with Medical Directors and other integrated care team members on the development of care management plans.
● Assist in problem-solving with providers, claims, or service needs.
● Maintain a current knowledge of CMS, DHHS requirements, licensure, and required training.
● Adhere to AmeriHealth Caritas policies and procedures.
● Create and support an environment that fosters teamwork, cooperation, respect, and diversity.
● Instill a work culture of continuous improvement, innovation, and quality.
● Perform any related duties and projects as assigned.

Qualifications

● Bachelor’s degree required.
● Active and unrestricted Registered Nurse licensure required.
● 1-3 years of experience with transition care and coordination activities.
● Proficient PC skills with Microsoft Office Suite
● Strong knowledge of Medicare/MMP/DSNP Integrated Care Management programs.
● Ability to communicate with beneficiaries who have medical needs or communication barriers.
● Ability to work independently or as part of a team.
● Ability to maintain positive relationships with internal and external customers.
● Local travel required, with mileage reimbursement to be provided.
● Field experience (home health, etc.) preferred.
● The position is remote and will service Wayne and Macomb counties in the state of Michigan.
● Candidate must be located within the Metro Detroit area or surrounding counties.