CareCentrix

  • Lead - Care Coordinator

    Job Locations US-FL-Tampa
    Job ID
    2018-5978
  • Overview

    The Lead Care Coordinator serves as a subject matter expert (SME) in the assigned unit and manages questions from the Care Coordinator staff. Works under general supervision.

    Responsibilities

    • Able to function independently as the lead Care Coordinator for the specific CCX program the team is responsible for.
    • Support oversight of the Care Coordinators including training, assignments, monthly quality audits and other assignments as needed.
    • Works in partnership with the specific CCX Program (ex: UM, iComply, PAC, and HomeStar) team to facilitate member and provider engagement in the program.
    • Able to effectively problem solve and bring forth recommendations to mitigate risks 
    • Works in partnership with their team and key stake holders ensure operational goals of the department are met/exceeded.
    • Knowledge of consumer information research tools to uncover contact, hospital and physician information which may not be available initially and applied to the program success.
    • Supports customer relations activities throughout the process inclusive of engaging the internal and external teams as needed.
    • As needed, inputs information into application and communicates/coordinates information with licensed staff and Care Coordinators.
    • Cross trained in all functions of the Care Coordinator duties including but not limited to: case setup, eligibility and benefits verification, notification of authorizations, staffing, and workflow distribution.
    • Understands that timely and accurate documentation is critical to the success of CareCentrix and be able to convey this to the Care Coordinators on the team.
    • Identify areas for process improvement and effectively communicate them to leadership
    • Must be committed to quality and high standards. Be able to provide issue resolution and escalation when appropriate.
    • Participates in special projects and performs other duties as assigned such as issue resolution and case research.

    Qualifications

    • High School Diploma or the equivalent plus a 1-3 years medical terminology or medical services experience required.
    • Minimum of two years insurance, quality improvement or healthcare operations required.
    • Excellent computer skills, including Microsoft Office applications with knowledge of basic spreadsheet, word processing, and data entry skills.
    • Experience in a call center environment preferred.
    • Knowledge of Utilization Management and URAC standards preferred.
    • Strong interpersonal skills.
    • This position requires excellent communication, customer and problem solving skills, as well as the ability to interact with all levels of management and a highly diverse clientele.
    • Must have strong organizational skills and be able to effectively manage and prioritize tasks.
    • Embraces the values of accountability, consistency, engagement, empowerment, respect and outstanding service.


    CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.

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