Health Plan Coordinator - Denver Health Medical Plan (Must Be a Colorado Resident)
- Denver, CO
- $20.97-29.36 per hour
- Permanent
- Full-time
Where is your life journey taking you?Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all:Humanity in action, Triumph in hardship, Transformation in health.Department Managed Care Administration*Must Be a Colorado ResidentJob SummaryUnder general supervision, provides basic care coordination and navigation of healthcare and community based services and manages assigned caseload. Works within a multidisciplinary team of care providers to identify physical, mental health, social and cultural needs. Removes barriers to care by identifying critical resources and assisting members to navigate through the health care system. Provides referrals to appropriate resources. Builds supportive, collaborative relationships with Members, helping to empower, educate and assist them with needs. Encourages members to obtain timely preventative healthcare while managing acute and chronic conditions.Essential Functions:
- Works under the direction of and in collaboration with the RN Care Coordinator, Clinical Care Coordinators and social workers to support the needs of the Member. (20%)
- Facilitates access to medical, behavioral health and community services (like transportation, food assistance, etc.). Assists members to apply for public benefits (e.g. SNAP, TANF, WIC). (15%)
- Serves as a community liaison and advocate by coordinating linkages or referrals to improve health, social, and environmental conditions for members. (15%)
- Coordinates and facilitates care and communication between health team, members, and members’ families. (10%)
- Maintains documentation of encounters with members and completes documentation requirements according to department standards. (10%)
- Serves as point of contact within and among healthcare services and organizations. (10%)
- Orients member/caregiver to health care delivery system, services, access, and resources. (10%)
- Supportive responsibilities for a defined caseload of Members. (5%)
- Obtains Member consent to participate in the program as well as to share clinical information with the Member’s care team (5%)
- High School Diploma or GED required
- 1-3 years experience in health plan case management, care coordination, or member navigation, preferred
- Bilingual in English/Spanish, preferred.
- Strong communication (written and verbal) and customer service skills.
- Ability to receive process and convey information in oral, written and keyboard formats.
- Ability to read documents and assimilate information
- Experience with windows-based computer programs and ability to use computer for data analysis and data display, required.
- Experience with Medical Management platforms used to document care coordination services, preferred.