Care Coordinator

About This Role

Develop, coordinate, and administer Member Management Programs, fostering effective communication within the healthcare delivery system. Directly assess individual member needs to coordinate case management and maximize contract benefits, ensuring quality care.

Responsibilities

• Develop, coordinate, and administer all activities related to Member Management Programs
• Effectively communicate with all members of the health care delivery system and group representatives
• Conduct individual member assessment and coordination of case management activities
• Coordinate case activity and maximize member’s contract benefits
• Evaluate member’s needs and develop alternative plans of treatment to provide quality care

Requirements

• Bachelor’s Degree or commit to actively pursue one upon hire
• Active License in good standing as a Registered Nurse (RN)
• Multi-State licensure as an RN or Alabama RN licensure with commitment to pursue other state licensures
• Minimum of three years of clinical experience in medical/surgical, psychiatric, and/or obstetrical settings
• Effective verbal and written communication skills with providers, subscribers, and group representatives
• Experience analyzing and making informed decisions in an autonomous setting
• Experience interpreting and communicating information orally and written with all levels of staff
• Experience in a position requiring independent decision-making skills
• Willingness to work a flexible schedule to provide telephone coverage

Qualifications

• Bachelor’s Degree or upon hire commit to actively pursue a degree
• Minimum of three years of clinical experience in medical/surgical health care fields, a psychiatric, and/or an obstetrical setting

Nice to Have

• Experience using negotiation skills
• Certified Case Manager
• RN experience in the ICU and ER