Clinical Care Coordinator

**in office position** NOT REMOTE**

Job Summary

Telephonic (email and/or mail if applicable) outreach to members based on prioritized lists with the goal of providing member guidance and support of care coordination programs. Answer and/or respond to inbound calls, mail and/or emails, resolving the needs of the member. When necessary to interact with a physician practice to fulfill the task at hand, the Care Coordinator will have a professional and positive approach and act as an extension of the health plan client.

Essential Duties & Responsibilities

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

• Maintain an exceptional level of customer service coupled with professionalism during each interaction with members, physician offices and applicable vendors.
• Provide detailed and clear documentation regarding member interaction in applicable platform by using proper and detailed call notes, providing a status update, or providing reference notes to external teams such as Case or Disease Management.
• Communication, as needed with Manager, Care Management department, physicians, etc., via e-mails, follow-up phone calls or mail correspondence.
• Responsible for meeting or exceeding provided objectives and goals, for quality and performance KPI's and metrics as required to obtain client/company expectations.
• Maintain departmental call volume requirements to include inbound and outbound
• Accurately and concisely document each call while continuing to interact with the member
• Work in conjunction with other team members to ensure any pending documentation/communication is completed accurately and forwarded accordingly
• Maintain a positive work atmosphere that embodies professional excellence, teamwork, and integrity.
• Ability to work under pressure and meet deadlines, while maintain a positive attitude and provide exemplary customer service
• Ability to work with minimal supervision
• Ability to navigate information coming from multiple platforms and prioritize duties appropriately
• Accurate data entry of information coming from the multiple avenues and platforms
• Must maintain compliance with all company policies and procedures
• Ability to handle a high workload and meet deadlines with a high level of accuracy.
• May be assigned other duties

Metrics of success for the Care Coordinator role will include:

• Meet or exceed monthly departmental goals as established by Operations
• Adhere to productivity standards for phone activity and phone queues/compliance standards to include Medicare guidelines, HIPAA, and minimum call volumes.
• Maintain daily productivity metrics for inbound/outbound calls
• Attendance

Qualifications / Requirements

• High School Diploma or G.E.D. required
• Associate degree preferred
• Bilingual a plus
• 2+ years prior call center/customer service experience preferred
• Healthcare industry experience preferred
• Ability to use a computer with good working knowledge of standard operating systems (Windows, MS Word, MS Excel, Internet, and other applicable systems.)
• Ability to read, analyze, and interpret medical supply publications, technical procedures, and sales training tools. Ability to write some external business correspondence. Ability to effectively present information and respond to questions from management, team members, and/or customers.
• Excellent verbal and written communication skills, including ability to effectively communication with internal and external customers.
• Strong listening skills
• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages. Ability to apply intermediate math skills.
• Ability to achieve thoroughness and accuracy when completing a task
• Ability to solve practical problems and deal with a variety of variables. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
• Knowledge of PHI/HIPAA Compliance rules and regulations a plus
• Professionalism in appearance, communications, and demeanor
• Must be able to work independently with limited supervision
• Must be organized and detail oriented

Job Type: Full-time

Pay: $15.00 - $17.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Experience:

• Customer service: 1 year (Preferred)
• Multi-line phone systems: 1 year (Preferred)
• Call center: 1 year (Preferred)
• Microsoft Excel: 1 year (Preferred)

Work Location: Hybrid remote in Largo, FL 33773