Description

JOB SUMMARY

The purpose of the Patient Care Coordinator (PCC) is to provide non-clinical assistance within the Medical Management department, as directed by the Manager / Supervisor. The PCC will assist with identification of barriers to member’s care, working with the clinical team to locate and assess resources needed to help manage a patient's healthcare and treatment needs. This position may assist either the Utilization Management or Case Management teams.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

Assist clinical staff with members inpatient or case management needs by: Requesting clinical information from providersAssuring discharges are place in the system in a timely mannerTrack SNF denial letters for signature and dateWork with Facility and Medical Director to set up requested peer-to-peer post-denial discussionsAssist with coordination of member’s health care and social service needs both within and outside the Medical Group and Health Plan. Develop rapport, establish and maintain effective interpersonal relationships with internal and external contacts at all levels. Coordinate the timely resolution of member and Provider concerns.Outreaching members post-discharge to assist determine if requested resources are providedFacilitate communication of the member Health Risk Assessment (HRA) and initial care plan (ICP) to the primary care physician (PCP). Communicate effectively, both verbally and in writing with individuals from varying cultural and ethnic backgrounds. Responsible for working closely with manager to address issues and delays that can cause a failure to meet or maintain compliance.Meets or exceeds production and quality metrics.Work directly with the provider(s) and plan to facilitate quality service to the member and provider. Attend all mandatory meetings and training.Maintain and keep in total confidence, all files, documents and records that pertain to the business operations.Collaborate, educate and consult with other departments to ensure consistent work processes All other job-related duties as it relates to the job function or as delegated by the management team.

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

One year Managed care experience (HMO, Medi-Cal/Medicare, Long Term Services and Supports and Community Health services) preferred. Experience in customer service. Problem solving and analytical skills. Ability to speak second language is preferred. Knowledgeable in principles and techniques to serve populations in diverse social and ethnic groups.Ability to communicate effectively both verbally and in writing.Experienced computer skills with Microsoft Word, Microsoft Outlook, Excel

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

Minimum Education: High School Diploma / GED RequiredPreferred Education: Associate DegreeEquivalent clinical work experience considered.

REQUIRED CERTIFICATIONS/LICENSURE

Include minimum certification required to perform the job.

Preferred: Medical Assistant certification

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Must be able to work in sitting position, use computer and answer telephoneAbility to travelIncludes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Office Work Environment

TRAVEL

Approximately 5% travel may be required

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Compensation and Benefit Information

Compensation

Pay: $17.20 - $25.70 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status.Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

Medical, dental, vision, disability, and life insurancePaid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.401k with up to 6% employer match10 paid holidays per yearHealth savings accounts, healthcare & dependent flexible spending accountsEmployee Assistance program, Employee discount programVoluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.2403030769