Care Coordinator (HEDIS Measures) SE WI Preferred Remote
Molina Healthcare is hiring for a Care Coordinator. This role is remote with a preference for location being in/near southeastern Wisconsin.The (non-clinical) Care Coordinator works with members, providers and multidisciplinary team members, focusing on specific HEDIS measures- Asthma, Diabetes and Hypertension. This role will assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.Highly Qualified Applicants will have the following qualifications-
A passion for providing the education needed to members to help manage and improve chronic health conditions.
Background or experience in social work, community health, Community Health Worker (CHW), public health, health education, Certified Health Education Specialist (CHES), or the like.
Above average computers skills (able to work proficiently in MS Outlook, Word, Excel)
Job Duties
Performs care coordination activities in collaboration with health care providers, other HCS staff, involved medical case managers, case management processors, community-based organizations (CBOs), and other providers as required to provide timely and accurate service authorizations and integrated care.
Assist members with social determinant of health needs, challenges in accessing health & community resources or other needs that fragment care and lead to poor health outcomes.
Documents all findings, contacts, and interventions in the electronic care management system.
Collaborates with state agencies, healthcare professionals and community support systems promote integrated care.
Expected to meet daily production standards in terms of member outreach.
Provide face-to-face care coordination activities in the communities where members reside.
Assesses for barriers to care, provides care coordination and assistance to member to address psychosocial, financial, and medical obstacle concerns.
Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements and converting these terms to configuration parameters.
Coordinating the authorization of needed services such as timely approval of durable medical equipment, pharmacy, and medical supplies.
Ensuring access to Medically Necessary physical health or Behavioral Health through assisting with appointments and transportation services.
Provides coaching/information for available health services or health education
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Job QualificationsRequired Education:
Bachelor’s Degree in a health care related field; however, relevant experience will be considered in lieu of degree.
Required Experience:
Para-professional whose background is anchored in social work or community health systems – per contract can be non-licensed.
Min. 1 year clinical experience
Preferred Qualifications:
Experience in social services, medical terminology
Experience in managed care environment; including knowledge or applicable state and federal regulations and standards.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.Key Words: HEDIS, CHES, Certified Health Education Specialist, WI, Public Health, Health Education, Communication, Instructional Skills, Training, Member Training, Teacher, Training, Health Education, CHW, Community Health Worker, Social Work, Case Management, Non-Clinical Case Management, Case Care, Case SpecialistPay Range: $16.4 - $31.97 / HOURLYActual compensation may vary from posting based on geographic location, work experience, education and/or skill level.