Patient Care Coordinator

SUMMARY: This position is located in the Business Office of the Carl T. Curtis Health Education Center (CTCHEC). The primary purpose of this position is to work with Medicaid Managed Care Organizations and Medicare Managed Care Organizations to identify and schedule open care opportunities for patients.

ESSENTIAL DUTIES AND RESPONSIBILITIES: A care coordinator should exhibit superb communication skills. They work with payers and providers to determine open care opportunities and schedule appointments as needed. Care coordinators possess leadership qualities needed for the betterment of a patient's health and quality of life, with responsibilities which may include:

• Scheduling and organizing open care opportunities for a patient's healthcare maintenance as identified from a Medicaid or Medicare MCO.

• Coordinating with Managed Care Organizations for open care opportunities
• Communicating between MCOs, Providers, and patients
• Monitoring progress of open care opportunities
• Schedule or organize transportation and other barriers that could prevent patients from getting healthcare.
• Maintaining patient confidentiality

• Working to assist with prior authorizations for medical and/or pharmacy claims

• Works with Patient Registration MSAs in screening for potential eligibility.
• Acts as back-up for Patient Registration and performs duties as required, including updating patient demographics and insurance eligibility.
• Works with the Business Office to maintain transportation billing for the facility
• Performs other duties as assigned.

QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below represent the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• A successful care coordinator candidate will have specific skills needed to fulfill their duties.
• They will utilize strong organizational skills necessary to systematize a care plan for several patients at once, while coordinating with diverse healthcare workers who hold varied schedules.
• Highly developed verbal and written communication skills will expedite and facilitate patient understanding of health needs while maintaining a high level of respect and confidentiality for the patient.
• The successful applicant will guide patients and teams with compassion,
• while demonstrating a complete understanding of healthcare procedures and practices.
• Knowledge of all program operations, priorities, and goals of various Alternate Resources programs.
• Ability to keep abreast of current changes in regulations and policies on Alternate Resources eligibility and medical terminology.
• A working knowledge of various third-party resources, which include Medicare, Medicaid, SSI, DHHS, Tribal Programs, Marketplace Health Insurance, and other related agencies.
• Practical knowledge of medical terminology and an understanding of ICD-10-CM and CPT Coding systems.
• Valid state driver's license required. Must be insurable.

EDUCATION AND/OR EXPERIENCE

• Associate's degree or two years of experience in the related field is highly desirable.
• Prior experience working with patients in either an administrative or clinical role.
• Familiarity within the healthcare realm is beneficial to successfully navigate through the system and easily adapt to the requirements of the field.
• Prior Authorization certification is highly desirable.

PLEASE NOTE: P.L. 93-638, Indian Preference and Tribal Employment rights Ordinance. (T.E.R.O) will be practiced; however, all qualified applicants will be considered.

*Please note that the job description is subject to change with or without prior notice.*

IF YOU ARE INTERESTED, PLEASE SEND APPLICATIONS RESUME TO:

OMAHA TRIBE OF NEBRASKA

ATTN: HR DEPARTMENT

P.O. BOX 368

MACY, NEBRASKA 68039

OR

EMAIL: othumanresources@theomahatribe.com

Must pass background check and pre-employment drug screen.

Salary : $18 - $20