CareCentrix

  • Lead - Care Coordinator

    Job Locations US-AZ-Phoenix
    Job ID
    2020-8622
  • Overview

    We are currently seeking a compassionate, experienced, and a highly-organized care coordinator to join our growing team of healthcare professionals. In this role, The Lead Care Coordinator serves as a subject matter expert (SME) and supports the Care Coordinnator staff. A Lead Care Coordinator is 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.

     

    Responsibilities

     

    • 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.
    • 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 experience 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.
    • Must have flexability to work rotating weekend shifts.
    • 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.

     

    We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

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