Personal Care Coordinator

Job Description

Job Description

For more details, please connect with me at 615-680-7247 or email me at Brijt@vgroupinc.com

Client : CalOptima Health Care

Job Title : Personal Care coordinator

Duration : 6 Months

Start Date : ASAP

Position Type : Contract

Location : Orange, CA (Onsite)

Interview Type : Web Cam / In-Person

Ceipal ID : CAL_PCC307_BT

Description :

CalOptima Health is seeking a highly motivated an experienced TEMPORARY - Personal Care Coordinator Sr to join our team. The Personal Care Coordinator Sr will perform a wide variety of advanced support activities for plan members. The incumbent will ensure regular communication of the member's annual Health Needs Assessment (HNA) or Health Risk Assessment (HRA) and care plan with the member, primary care provider (PCP) and health care team. The incumbent will regularly assess the quality of service given to the member's care by identifying barriers and assisting in improving these barriers for all levels of care. The incumbent will maintain strong working relationships with the PCP and health care team to ensure member access to timely services and coordination of care.

Duties & Responsibilities :

95% - Program Support

Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.

Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department.

Maintains strong working relationships when collaborating with the PCP and health care team to ensure timely communication of member's clinical information and ensures appropriate documentation of all interventions. Also, notifies member's care team of key event triggers.

Collaborates with licensed professionals in development of a care plan for each member, incorporating the HNA or HRA all assessment findings. Facilitates communication of care plan to the PCP and member, as necessary.

Develops and implements a member's specific care plan which includes prioritized Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) goals.

Facilitates and participates in interdisciplinary team meetings as applicable.

Processes and maintains complex or sensitive documentation of member's case and care plan within CalOptima Health's medical management system.

Facilitates referrals to Behavioral Health Services and identifies the need for referrals to Long-Term Support Services and community resources.

Facilitates transfers to member's assigned case manager in accordance with member needs, when appropriate.

Anticipates longer-term and more unique member needs by providing guidance in understanding and accessing the benefits they are entitled to under Medicare and Medi-Cal, as appropriate.

Maintains compliance with established departmental productivity guidelines; compiles and conducts basic analyses and reporting of productivity metrics to management as required.

Coordinates and maintains cases in current case load in accordance with case management standards. Assists with collection of health risk or health needs assessments as well as gathers medical records as needed.

Provides regular outreach to assigned members and evaluates quality of service given to members according to department contact standards.

Serves as the main point of contact for assigned members to anticipate longer term member needs.

Works with Case Management staff to expedite the resolution of member concerns.

5% - Completes other projects and duties as assigned.

Minimum Qualifications :

High School diploma or equivalent required PLUS 2 years of experience working with the needs of members, such as but not limited to pediatric members, seniors or persons with disabilities (SPD) and / or special populations (e.g., homeless or at risk of homelessness) in a customer / member service capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications :

Bachelor's degree in healthcare management, social work, human services or related field.

2 years of experience with health maintenance organization (HMO), Medi-Cal and health services.

Experience working with individuals with behavior health conditions or substance use disorders.

Bilingual in English and one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).

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