Care Coordination-Administrative
Position Summary: The Community Supports Coordinator for Private Duty will provide referral assignments to our Network Members to ensure access to Personal Care Homemaker Services and or Non-Medical Respite as authorized by our payors. Minimum Qualifications: B.A. in human development, social work, psychology, counseling, rehabilitation, gerontology sociology or related field. Minimum of two years of experience working in healthcare or multidisciplinary community-based settings providing case management or care coordination services. (Adult/people with disabilities focused social work preferred.) Minimum of two years of experience working with diverse individuals and families experiencing health related social needs. Bilingual preferred Key Characteristics, Skills, and Competencies Highly motivated with minimal supervision and strong attention to detail. Excellent organizational skills and the ability to multitask and work under pressure. Adaptable, dependable and a team player Strong verbal and written communication skills Strong data entry and computer skills experience. Knowledge of community-based programs. Ability to work with multidisciplinary team, clients and their families. Passionate about improving the lives of diverse individuals and families experiencing health related social needs. Responsibilities: Responsible for the receipt, review, and timely assignment processing of member referrals from internal departments and external referrals from various Managed Care Plans (MCPs), using various portals, encrypted emails, efax, referral forms, and other sFTP platforms. Create accounts for all referrals and input contact information in Partners’ database. Timely input of referrals into internal data systems and follow up of referral disposition in Partners’ database systems, including Managed Care plan spread sheets, portals and or platforms (as required by MCPs). Provide daily communication with Home Care Agencies, to assign referrals, obtain referral disposition feedback, provide authorization start and end date follow up, authorization extension and modification follow up and processing and support HCA to ensure quality service delivery is maintained to meet contractual requirements and compliance. Liaison with internal teams and departments to provide linkages to services or support for PD members or HCAs as appropriate. Conduct eligibility checks for all members and obtain discharge paperwork and or survey data as requested from payors. Make outbound calls to members and conduct outreach and read referral script and upload necessary supporting documentation into Partners database and or payor platforms. Attend weekly team meetings, trainings and other program related meetings that support Partners in Care Foundation services and programs. Review PD reports and or program dashboards and follow up on referral items that are pending and or items requiring additional research, clarification, and or corrections, including but not limited to billing details, referral data etc. Work collaboratively with PD team members to onboard and provide orientation training for new PD network members and ensure all necessary documents for PD program are shared with new members, revised and amended as needed. Address program related calls, emails and inquiries from various entities including HCA’s, MCP members, Payors, Partners’ staff, community members and elevate disputes or concerns to supervisor. Partners in Care Foundation is an equal opportunity employer. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race (including hair texture and protective hairstyles, such as braids, locks, and twists), color, national origin, ancestry, religion, sex, sexual orientation, pregnancy (including childbirth, lactation/breastfeeding, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics, as well as those of family members), veteran status, uniformed service member status, gender, gender identity, gender expression, transgender status, arrest or conviction record, domestic violence victim status, credit history, unemployment status, caregiver status, sexual and reproductive health decisions, salary history or any other status protected by federal, state, or local laws. All qualified applicants will receive consideration for employment and reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the position.
