Job Description
Salary: Competitive, based on experience
We are seeking passionate and dedicated Clinical Care Coordinators (Licensed Registered Nurses) for a remote position based in the District of Columbia. This role provides an opportunity to make a meaningful impact on the lives of individuals while working with a supportive, mission-driven team.
Key Responsibilities:
Manage a caseload, engaging with enrollees based on their individual care needs and stratification levels.
Contact enrollees at scheduled intervals or more frequently if needed, ensuring consistent and personalized care.
Conduct in-home or location-based visits to assess needs, identify barriers, and close gaps in care.
Complete care coordination activities that prioritize quality and timeliness, in compliance with organizational policies and national standards.
Work closely with the Senior Care Manager to review and prioritize cases, address potential risks, and monitor utilization concerns.
Consult with Senior Care Manager or other experts for guidance on complex cases.
Document all findings and interactions promptly and accurately, adhering to confidentiality policies.
Participate in discharge planning and contribute to the creation of individualized, actionable care plans.
Educate enrollees and caregivers on health services, including the importance of preventive care and compliance with EPSDT.
Apply your expertise to manage a variety of conditions within the target population, coordinating resources and services as needed.
Review vendor or contracted provider reports and ensure timely follow-up care.
Guide enrollees through transitions in care, ensuring a smooth process when moving between providers or healthcare systems.
Facilitate the authorization of services requiring approval and ensure clear communication with providers, enrollees, and families.
Maintain a professional, courteous, and customer-focused demeanor in all interactions.
Utilize medical terminology and apply effective time management and organizational skills in day-to-day responsibilities.
Qualifications:
3-5 years of experience in managed care or care management settings.
3-5 years of experience in clinical or community resource environments.
Excellent verbal and written communication skills.
Bilingual (Spanish-speaking) preferred.
Strong understanding of medical terminology.
Proficient in using computer systems and applications, particularly the Microsoft Office Suite.
Exceptional organizational skills with the ability to manage multiple priorities effectively.
Ability to interpret and apply departmental guidelines and make sound decisions.
Ability to work efficiently under pressure, meeting deadlines while maintaining a positive, customer-centered approach.
Comfortable participating in professional, multidisciplinary meetings and collaborating with internal and external teams.
Licensure and Certifications:
Licensed in DC as a Social Worker (LICSW) or Registered Nurse (RN).
Certification as a Case Manager is preferred.
Education:
Associate's degree required; Bachelor's degree preferred.
Additional Information:
This role involves moderate mental and visual stress, with periods spent using a computer keyboard and monitor.
Flexibility is required, as some weekend, evening, or early hours may be needed to accommodate the needs of the members.
Employment Type: Full-Time
Salary: $ 43.00 Per Hour
Job Tags
Hourly pay, Full time, Weekend work, Afternoon shift,