Description: This position is located in Cypress, CAPosition Summary
The Outreach Program Coordinator is responsible for providing administrative support to the Case/Care Management team including Hospitalist’s, SNF’s, Members and PCP’s. The goal is to assist in the prevention and reduction of transitions of care to the hospital, skilled nursing or emergency department. By ensuring patients are well supported during transitions of care and along the entire continuum of care. The Outreach Program Coordinator will be responsible for assisting in the care coordination of any member who has been identified for care management services or have requested such services.Responsibilities:
- Contacts the member either in the hospital or at home to assist and conducts post discharge assessment after discharge to ensure that all needs have been met, coaches member to ask questions to ensure understanding of discharge instructions.
- Contacts members as directed by the Case Manager that need assistance with coordination of care
- Contacts members that are new to the IPA either by phone or mail, introducing the care coordination team and process. Initiates the care coordination care plan and schedules initial assessments for the Case Manager
- May initiate the initial assessment for low risk members and coordinates post discharge appointments with PCP’s and specialist. Makes timely follow up calls and assessments on all assigned that have had ER encounters
- Assist Case Managers with planning for discharge by generating authorizations and scheduling appointments for services needed within 3-5 business days of discharge. Distributes discharge plan of care to the members of the care team.
- Retrieves medical records, HRA, Trigger reports Claims documents from Health Plan, providers, etc. Attaches documents to cases in Essette
- Collaborates with the hospital and SNF staff to obtain daily census, discharge summaries, medication reconciliation information. Documents receipt in Essette
- Documents activities in HP specific logs such as the transition of care logs for SNP and CMC members
- Maintains spreadsheets as documentation for elements required in the Model of Care for SNP & CMC members
- Refers those members with unmet needs or high risk for readmission or untoward outcomes to the Case Manager for higher level of case management and continued follow up.
- Schedules Home bound or Palliative Care visits as directed by PCP, Case Manager, or hospitalist
- Works together with the Case Manager to support and coach member, identifying support systems, providing information and education on community based resources.
- Support the safe, continuous delivery of medically necessary care and supportive ancillary services in the inpatient and transition to home or SNF setting, utilizing the health plan ancillary grids.
- Identifies patient complaints or concerns and reports to the appropriate personnel.
- Documents all activities in Case Management system and reports monthly statistics for review
- Fosters positive interaction and relationships with all internal departments and external contacts.
- Prevent and avoid harassment and discrimination. Respond promptly to any complaints in accordance with policy in employee handbook.
- Adhere to all Tenet Health and Coast Healthcare Management policies and procedures.
- Perform other assigned duties / special projects on an as-needed basis.
High School Diploma (or equivalent)Preferred Education2 years CollegeMinimum Experience
- 1+ years’ experience in an IPA or other healthcare company
- Data entry experience in a clinical setting using medical terminology, ICD9 and CPT coding
- Knowledge of EZ-Cap information system preferred
- Experience with computer programs (Windows, Word, Excel, Mail Merge, Fax Blast, PowerPoint)
- Excellent organizational skills
- Excellent communication and assessment skills
- Willingness to learn new tasks
Job: Clerical/AdministrativePrimary Location: Lakewood, CaliforniaHospital Location: Coast HealthcareJob Type: Full-timeShift Type: Days Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.
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