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High Intensity Coordinator - Full Time, Days at Prospect Medical Systems - CA in Orange, California

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

High Intensity Coordinator - Full Time, Days

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

This position will serve as a liaison between Health Plan members, Prospect, Primary Care Provider (PCP), specialists and other members of the health care team. The High Intensity Coordinator (HIC) will identify and reduce barriers to members' care, assist the member in locating and accessing resources and educate the member on the importance of accessing care promptly. The HIC will serve as the primary point of contact for the member and will be an integral part of the member's interdisciplinary care team. The HIC provides support to the member as they self-navigate the health care system and works closely with member's case management team to resolve access, medical and psychosocial related issues. This HIC must be able to efficiently manage and prioritize assigned caseload while working with a licensed clinical professional (case manager) to ensure optimal coordination of care for the Health Plan members.

Job Responsibilities/Duties


  • Maintains primary responsibility for management of a panel of members with support of care management team
  • Assists members with working toward established health care goals telephonically. In-person visit may be needed for certain members and will be determined on a case to case basis.
  • Collaborates with the health plan, PCP, and health care team to ensure timely communication of member's clinical information.
  • Works closely with case managers in the development of member friendly care plans for each member, incorporating the HRA and all other assessment findings.
  • Notifies member's care team of key event triggers.
  • Facilitates warm transfers to member's assigned case manager in accordance with member needs, when appropriate.
  • Identifies the need for, and facilitates, referrals to Long Term Support Services (LTSS), Behavioral Health and other community resources.
  • Guides members in understanding and accessing the health plan benefits they are entitled to.
  • Facilitates and coordinates interdisciplinary care team (ICT) meetings including sending invitations to member, caregivers, PCP, specialists, and others member ICT team.
  • Maintains documentation of member's case, care plan, interventions, and interdisciplinary care team within Prospect's care management system.
  • Mail out educational and community resources information to members
  • Compile clinical documentations as required for ICP/ICT bundle submissions.
  • Assist Case Managers obtaining medical records for members.
  • Generate letters, faxing to PCP and mailing to members along with resources.
  • Maintains compliance with established departmental productivity guidelines.
  • Complete required Health plan and company trainings
  • Maintain internal department trackers and reports.
  • Other projects and duties as assigned

Qualifications

Minimum Education: High School Diploma or equivalent required. Associate degree or higher preferred. Certified Medical Assistant. Medical Terminology certificate preferred.

Minimum Experience: Excellent written and verbal communication skills (60 WPM). Exceptional customer service and conflict resolution skills. Must be able to work independently. Ability to multi-task, prioritize, and work in a fast pace environment. Must be proficient in Microsoft Office navigation, Excel, Outlook, Teams and Word and/or IDX knowledge. Knowledge of HIPAA regulations preferred. Bilingual language proficiency preferred. Knowledge of managed care and healthcare preferred. Working with the needs of seniors or persons with disabilities (SPD) in a customer/member service capacity, HMO, Medi-Cal and/or health services preferred.

Req. Certification/Licensure: Certified Medical Assistant. Medical Terminology certificate preferred.

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:


  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

Prospect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol. Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm. For this reason, we require applicants to pass a screening for drug use as a condition of employment. This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.

How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm





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