Care Coordination Specialist - Roseville, CA

• Conduct assessments to identify individual member care needs and preferences to provide high-quality care coordination.
• Collaborate with members/legal representative, health plan, and providers, community-based organizations (CBO), interpreters and others in to aid members in accessing dental care. Work with members and providers to coordinate necessary dental care.
• Leverage a variety of resources, or combination of resources, to assist the member in coordinating care. Remove barriers to care such as assisting with appointments, transportation, language assistance. Identify members with special healthcare needs or other identified target populations that are eligible for case management.
• Monitor members are actively receiving appropriate care/scheduled care and complete their goals.
• Maintain and record decisions, actions, and outcomes for members receiving care coordination. Set up tasks, reminders and follow up on missed appointments.

• A minimum of three (3) years of experience in a relevant Care Coordination position in the healthcare or insurance industry with Medicaid and/or Medicare knowledge and experience strongly desired.
• Medi-Cal Dental health experience is strongly preferred. Strong knowledge of dental treatment authorization request processes, procedures, and documentation is preferred. Strong knowledge of dental health management processes and procedures to include treatment documentation, record keeping, and chart narratives is required.
• Professional or personal experience supporting individuals with disabilities, chronic illnesses, or experiencing homelessness; including strong understanding of social determinants of health preferred.
• Familiarity with care coordination methodology and the ability to work independently and in a team setting.

• Must be a resident of the Greater Sacramento area of California
• This posting is intended for pipelining. We will accept applications on an ongoing basis.

Gainwell Technologies