Care Coordinator II

• Hours: Full time - 40 hours per week
• Work Schedule: Monday to Friday, 8:30 am to 5:00 pm EST or CST (depending on where you live in KY)
• Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved.
• Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities.
• Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate
• Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed
• Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan
• Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service
• May support performing service assessments/screenings for members and documenting the member's care needs
• Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed
• Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards
• Ability to identify needs and make referrals to Care Manager, community-based organizations, and Disease Manager
• Provide education on benefits and resources available
• Performs other duties as assigned.
• Complies with all policies and standards.
• We are a telephonic team reaching out to our most vulnerable Medicare members who remain non-compliant for their annual preventive screenings and preventive visit (outbound calls, about 10 calls per hour), documenting assessment applications.
• Proficient in Excel and Word doc.
• We expect our team to reach out to 10 members per hour.
• The role is designed to assist the members with scheduling an appointment with their provider and addressing all open care gaps.
• This role provides educational information, along with SDoH barriers support.
• Weekly office hours for questions and monthly 1on1's with provided support via group chat.
• Resource folder available to utilize for questions.

• Key Skills; Ability to fully engage with members in a conversational manner while providing support for needed medical care.
• Ability to work on multiple sites and with multiple screens while continuing to engage the member- no dead air.
• Complete assessments needed to close HEDIS care gaps.
• High School Diploma
• Requires 1 - 2 years of related experience (call center or provide office).
• Proficient in Excel and Word doc.
• Complies with all policies and standards.
• Knowledge with medical terminologies

Pyramid Consulting