Care Coordinator

Job Description

The care coordinator will perform the following essential activities of care coordination: Assessment – The care coordinator will assess information about a members’ medical care needs, social situation and functioning to identify individual needs in order to identify members medical needs and develop a plan of care that will address those needs. Planning – The care coordinator will involve the enrollee and other significant parties in the determination of specific objectives, goals, and actions as identified through the assessment process. The care coordinator will use the information to develop a plan specific to the enrollee’s medical needs. Implementation – The care coordinator will facilitate and execute specific interventions that will lead to accomplishing the goals established in the plan of care to ensure the member’s health, safety, and welfare. Coordination – The care coordinator will organize, integrate, and modify the resources necessary to accomplish the goals established in the plan of care. Monitoring – The care coordinator will gather sufficient information from all relevant sources in order to determine the effectiveness of the plan of care. Evaluation – At appropriate intervals, the care coordinator will determine the plan of care’s effectiveness in reaching desired outcomes and goals. This process might lead to a modification or change in the plan of care in its entirety or in any of its component parts.

Qualifications

Education
Registered Nurse with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience
Minimum of 5 years healthcare w/ 3 years clinical experience required.
2 years’ experience in Utilization Management, Case Management or Managed Care. Skills/Certifications
Must be PC literate with extensive knowledge of Windows and Microsoft Office.
Must be able to pass Windows navigation test.
FACETS and Care Advance experience preferred.
Exceptional skills of independence, organization, communication, problem-solving, professional interaction, and human relation skills, as well as analytical skills and problem solving ability
Ability to work within specified timeframe requirements.
Valid Driver’s License
TB Skin Test (applies to coordinators that work in the field)
Certification as a Case Manager (CCM) preferred; required to take examination when eligible.
Milliman’s Certification Preferred
Must be willing to obtain within 1 year from date of hire.
Position requires 24 months in role before eligible to post for other internal positions

Additional Information

Riya Khem

Life Science Recruiter 

Integrated Resources, Inc.

IT Life Sciences Allied Healthcare CRO

Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I

DIRECT # - 732 -844-8721 | (W) # 732-549-2030 - Ext - 311 |(F) 732-549-5549