Coordinator III - Care Management Associate at US Tech Solutions, Inc.

Duration: 6 months contract

Job Description:

• Utilizes critical thinking and judgment to collaborate and inform the case management/concurrent review process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management/concurrent review tools and resources. Will assist with discharge plans, and outreach to members, assist with HH/DME issues.

Responsibilities:

• Enhancement of Medical Appropriateness and Quality of Care:- Using holistic approach consults with utilization management clinicians, hospital discharge planning staff, supervisors, and/or other health programs to overcome barriers to meeting goals and objectives;
• Coordinates care with providers as a part of comprehensive and proactive discharge planning.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.

Experience:

• Case management and discharge planning experience call center experience

Skills:

• Discharge planning
• Care management
• Case management
• Call handling experience.

Education:

• High school diploma or GED required