POSITION SUMMARY:

The CHC Managed Care Coordinator will facilitate communications between the provider, the insurance company and the patient. They are responsible for ensuring the medical services are provided per a set of protocols. Will assist the Care Teams (provider, medical assistant, behavioral health provider, etc) by coordinating care to high-risk/other patients to offer complete preventive care for all patients who are CHC patients/or are assigned by the insurance plan. May outreach to patients to schedule appointments based on the protocols established by LCT/HEDIS/Insurance Plans. Participates in continuous quality management, to positively affect patient and system outcomes to improve care. Will be responsible to report data and other measures of progress made towards improvements aligning with Value Based Programs.

PRINCIPLE RESPONSIBILITIES:

The following information is intended to be representative of the essential functions performed by incumbents in this position and is not all-inclusive. The omission of a specific task or function will not preclude it from the position if the work is similar, related or a logical extension of position responsibilities.

1. This position will be the liaison between the insurance plan, the provider/ provider teams, and the patient.

2. Will assist the Care Teams (provider, medical assistant, behavioral health provider, etc) by coordinating care to high-risk/other patients to offer complete preventive care for all patients who are CHC patients/or are assigned by the insurance plan.

3. Follows the goals and objectives and will support specific policies and procedures outlined by the Lead Clinical Team.

4. May outreach to patients to schedule appointments based on the protocols established by LCT/HEDIS/Insurance Plans.

5. Based on CHC protocols/Insurance Plans based on CHC approved agreements, will take next steps in coordinating the patient’s screenings

6. Participates in continuous quality management, to positively affect patient and system outcomes to improve care.

7. Will be responsible to report data and other measures of progress made towards improvements aligning with Value Based Programs.

8. Demonstrates autonomy, human relations, and effective communication skills.

9. Attends all meetings as assigned by the Data Analyst/Managed Care Director.

10. Assures all tasks are functioning as planned and corrects any concerns or problems that may exist in a fast and effective manner.

11. Performs other related duties as assigned.

QUALIFICATIONS:

1. Demonstrated ability to work effectively with all administrative and clinical personnel and management leaders in the development and implementation of clinical principles and policies of practice, performance measures, health care planning, and quality assurance programs.

2. Minimum 2 years clinical experience.

3. Ability to provide care to the population served.

4. Must have demonstrated written and verbal communication skills.

5. Has the ability to set priorities and problem solve in in a fast and effective manner

6. Ability to interact, relate and communicate well with clinic staff and Providers; must be an effective team builder.

7. Bilingual capabilities (Spanish-English) is required.

8. Computer literacy is required.

9. Experience analyzing data is needed.

Job Type: Full-time

Pay: $50,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement

Schedule:

• 10 hour shift
• 8 hour shift
• Monday to Friday

Work setting:

• In-person

Ability to commute/relocate:

• West Valley City, UT 84119: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Customer service: 1 year (Preferred)

Language:

• Spanish (Required)

Work Location: In person

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