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Outreach Coordinator - ICM Community Partners Program at Tufts Health Plan in Watertown, Massachusetts

Posted in Other 30+ days ago.

Type: Full Time





Job Description:

We enjoy the important work we do every day on behalf of our members.

Job Summary

The Outreach Coordinator (Coordinator) is the primary point of initial contact for all new Accountable Care Organization (ACO) and Managed Care Organization (MCO) members who are auto-assigned, or referred by MassHealth, or self-referred into a Community Partners (CP) Program. The scope of this role includes Long Term Support Services (LTSS) CP members. The Outreach Program is managed under the direction of the Clinical Manager.
The Coordinator works under the daily direction of the Lead Outreach Coordinator and is responsible for the telephonic outreach and the scheduling function for all LTSS CP members, based on standard workflows as documented in the CP Program Model of Care. The Coordinator manages the HTR process based on documented work flows, including conducting research to locate members and communicates with CPs and ACO points of contact for additional information.
The Coordinator is responsible for scheduling the member's CP assessment with a care manager within 90 days of referral. The Coordinator conducts him/her-self in a professional and respectful manner and documents the outreach activities in the member's record (CCMS).
The Coordinator acts as a communication liaison to the care management team, Population Health Workers and other stakeholders as applicable to the Program. The Coordinator documents telephonic activity in CCMS and maintains the member \\"tracker\\" with current outreach status and scheduling outcome, including Hard to Reach (HTR) status and terminations.

Job Description

Scheduling Members
* Reviews Monthly Tracker for assigned LTSS CP members requiring assessments and care planning
* Reviews State file to identify and confirm each member's eligibility
* Initiates outreach cycle and documents HTR or member refusal status as applicable
* Facilitates member engagement and educates the member about the CP program
* Schedules members based on preferences and regulated timelines
* Reschedules members as needed based on member preferences
* Communicates member information as needed to the care manager, including escalating urgent follow up
* Maintains accuracy of the outreach tracker on a daily basis, including updating member status and terminations
* Documents outreach activity and scheduling outcome in the member record (CCMS)
Manages HTR member
* Manages the member HTR process to ensure any needed additional contact information is found.
* Research existing internal data systems to identify possible additional/different member contact information
* Engages ACO and CP stakeholders in researching HTR members
* Initiates outreach cycle for found members
* Documents research results, ACO/CP outreach, and member related outcomes in CCMS.
* Updates \\"Tracker\\" with changes in HTR status
* Ensures scheduling activity supports timely assessments and compliance with contract requirements
* Performs other scheduling duties as assigned based on continuous monitoring

Requirements

EDUCATION:
* High School degree or GED required
* Associates degree in related administrative or clinical field strongly preferred
EXPERIENCE:
* Minimum 3 years of experience working within an administrative environment preferably in managed care, community based organization, physician practice, customer service department, and supporting professional staff
* Working knowledge of excel and basic understanding of on line clinical documentation systems
SKILL REQUIREMENTS:
* Exceptional internal and external customer service skills
* Proven ability to be organized, have the ability to prioritize and multi-task
* Must be self- directed and demonstrate ability to resolve problems and manage escalated customers
CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!.

Tufts Health Plan is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here. If you d like more information on your EEO rights under the law, please click here.


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