Managed Care Coordinator

Location: Corporate Office, Commerce-CA

Position Purpose:

The Managed Care Coordinator will collaborate closely with healthcare teams and providers to enhance patient care coordination. Responsibilities include contacting, scheduling, and educating patients on preventive care. Additionally, the Managed Care Coordinator will manage new member outreach, coordinate annual wellness exams, monitor emergency department utilization, and utilize Care Gap Reports for tracking and reporting purposes.

Principal Responsibilities: 

1. Manage JWCH’s patient population's health by conducting friendly reminder calls and assisting in scheduling appointments seamlessly.
2. Contacting newly assigned members and scheduling their Initial Health Assessment (IHA).
3. Educating patients on the importance of preventive care and annual check-ups to promote overall health.
4. Increasing utilization of preventive care services among our patient population.
5. Updating department dashboards for weekly and monthly reporting purposes.
6. Enhancing continuity of care by fostering and managing relationships with members.
7. Connecting members with relevant community resources to improve patient health, well-being, satisfaction, and reduce healthcare costs.
8. Conducting conversations with clients and visitors to assess informational needs.
9. Assisting clients from diverse cultural backgrounds in understanding access and limitations to healthcare services within the Health System.
10. Obtaining and verifying patient demographic information to ensure accuracy in records.
11. Adhering strictly to standards regarding client confidentiality, informed consent, and disclosure as required by law and agency policy.
12. Screening patients over the phone in collaboration with assigned Registered Nurses as necessary.
13. Verifying eligibility through state Medi-Cal, Health Plan, and MHLA websites.
14. Serving as a liaison between clients and the healthcare team to facilitate effective communication and care coordination.
15. Assisting with daily maintenance of Emergency Department (ED) member lists, including contacts, tracking, and follow-ups.
16. Educating clients about available health coverage programs and referring them to Enrollment Specialists for eligibility screening as required.
17. Working closely with the outreach team to welcome new clients, facilitate intake processes, and assist with scheduling.
18. Attending general staff meetings as necessary to stay informed and contribute to organizational goals.
19. Performing other relevant tasks and duties as assigned.

Requirements:

1. Medical training or experience preferred (i.e. Medical Assistant Certification)
2. Minimum of 2 years of experience in a healthcare setting, preferably in care coordination, patient advocacy, or case management.
3. High school diploma or GED equivalent.
4. Proven experience working effectively with clients and staff from diverse socio-economic, ethnic, and cultural backgrounds.
5. Strong customer service skills with a track record of providing excellent service.
6. Ability to multitask in a fast-paced environment and collaborate effectively within a team to achieve shared goals.
7. Proficiency with Windows-based computer programs and ability to learn new software quickly.
8. Exceptional verbal communication skills, demonstrating clarity and professionalism.
9. Pleasant and professional telephone manner.
10. Typing speed of at least 40 words per minute.
11. Willingness and ability to travel between different sites as needed.

*All JWCH, Wesley Health Centers workforce members are recommended to be fully vaccinated and boosted against COVID-19.

Employee Benefits:

At JWCH Institute, Inc., we believe in taking care of those who take care of others. If you work 30 hours per week, you’ll enjoy competitive pay and a robust benefits package that includes:

• Medical, Dental, Vision
• Monthly employer-sponsored allowance for assistance with health premiums.
• Funded Health Savings Account (up to deductible) to assist with carrier-approved medical expenses.
• Paid time off (vacation, sick leave) and 13 paid holidays.
• 401(k) Safe Harbor Profit Sharing plan.
• Mileage reimbursement.
• Short- and long-term disability plans (LTD/STD).
• Life insurance policy & AD&D, and more!

Become part of a team where your work matters. Apply today and help us change lives, one patient at a time.

JWCH Institute, Inc Wesley Health Centers is an Equal Opportunity and Fair Chance Employer.