CareFirst Careers

Early Intervention Care Coordinator (DC Medicaid)

Resp & Qualifications

PURPOSE:

The Early Intervention Care Coordinator supports the Early Intervention Care Manager and Director of Case Management for Early Intervention, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the enrollee and the reimbursement source.  The Early Intervention Care Coordinator will adhere to the principle of the Quadruple Aim – improving enrollee experience, better outcomes, improved clinical experience, lower costs while pursuing health equities for our enrollees.

 

The Early Intervention Care Coordinator will be fully engaged with the team direction of addressing problems and provide guidance in the coordination of services for enrollees. The Early Intervention Care Coordinator will provide outreach to enrollees, build trust-based relationships, provide access to community resources and social programs, as well as providing an administrative role in the team goal to ensure the establishment of performance metrics and performance guarantees. The Care Coordinator tracks referrals and outcomes of community and social programs and is part of an effective, efficient workforce to support all aspects of the Case Management department across the continuum of care settings, clinical programs and services for enrollees. The role works closely with the Care Managers to develop and operationalize sustainable processes to support functional improvements for the organization.

PRINCIPAL ACCOUNTABILITIES: 

Under the general direction of the Director of Case Management for the Special Health Care Needs population, the Care Coordinator’s accountabilities include, but are not limited to, the following (specific goals for Case Management Department are determined on an annual basis in accordance with directives from the executive board of CareFirst Community Health Plan Blue Cross Blue Shield):

 

  • Compile data for Care Coordination and Case Management needs
  • Establishing accountability and agreeing on responsibility
  • Communicating and sharing knowledge
  • Assisting with transitions of care
  • Understanding enrollees needs and goals
  • Monitoring and follow-up of in response to patients needs
  • Supporting enrollees’ self-management goals
  • Linking enrollees to community resources and coordinate care
  • Work to align resources with patient and populations needs
  • Reach out to and engage enrollee
  • Respond quickly and effectively to changes in enrollee needs
    • Assist in the minimization of the fragmentation of care services and adverse outcomes.
    • Assist in the monitoring of documentation to reflect the necessary communication with the enrollee, family, physicians, and other health care providers to ensure the enrollee’s progression in meeting the established care plan goals.

QUALIFICATION REQUIREMENTS:

To perform the job successfully, an individual should demonstrate the following competencies:

  • Analytical   | Experience working with statistical methodologies, analytical and statistical theories. Knowledge of applied use of data in health program monitoring and evaluation.
  • Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.
  • Project Management   | Communicates changes and progress; Completes projects on time and budget.
  • Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
  • Customer Service   | Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
  • Interpersonal Skills   | Solution oriented approach to conflict and challenges; Maintains confidentiality; Practices effective listening skills; Maintains professional demeanor; Remains open to others' ideas and tries new things.
  • Oral Communication   | Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Actively participates in meetings.
  • Written Communication   | Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Able to read and interpret written information.
  • Quality Management   | Demonstrates accuracy and thoroughness. Applies quality assurance principles to data management activities.
  • Diversity   | Shows respect and sensitivity for cultural differences; Promotes a harassment-free environment and respects diversity.
  • Ethics   | Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
  • Organizational Support    | Understands organization's goals and values and role in achieving those goals; Follows policies and procedures; Completes administrative tasks correctly and on time.
  • Strategic Thinking - Develops strategies to achieve organizational goals; Understands organization's strengths & weaknesses; Analyzes market and competition; Adapts strategy to changing conditions.
  • Judgment   | Displays willingness to make decisions; Includes appropriate people in decision-making process; makes timely and data-driven decisions.
  • Motivation   | Sets and achieves challenging goals; Demonstrates persistence and overcomes obstacles.
  • Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Ability to multi-task.
  • Professionalism     Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
  • Quality     Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
  • Safety and Security - Observes safety and security procedures; Reports potentially unsafe conditions.
  • Adaptability   | Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able pivot work with frequent change, delays, or unexpected events.
  • Attendance/Punctuality | Consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.
  • Dependability   | Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
  • Initiative   | Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Looks for and takes advantage of opportunities; Asks for and offers help when needed.

OTHER SKILLS

LANGUAGE SKILLS   | Ability to read, analyze, and interpret health and science periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the public.

 

MATHEMATICAL SKILLS   | Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Knowledgeable of advanced statistical methodology.

 

REASONING ABILITY | Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

 

COMPUTER SKILL | To perform this job successfully,  an individual should have advance knowledge and proficiency in statistical data processing and visualization software such as Tableau, Spreadsheet software, and SAS, as well as Microsoft Office, Word Processing software, and SharePoint.

 

PHYSICAL DEMANDS | The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand; walk; climb or balance; stoop, kneel or crouch.

 

The employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds.

 

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

 

WORK ENVIRONMENT | The noise level in the work environment is usually minimal to moderate. The work environment is fast paced with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

 

Required Education/Experience/Skills/Abilities:

  • Associate’s degree in Health Care Administration, Science or related field preferred or a minimum of two years of experience working in a health-related field and/or managed care environment; BA in related filed preferred.
  • Experience working with case management data systems.
  • Understanding of community resources, treatment options, home health availability, funding and special programs.
  • High degree working knowledge of HIPPA regulations.
  • Experience with working in field -based environments with flexibility and adaptability.

 

 

 

 

 

 

 

 

 

 

 

 

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Closing Date

Please apply before: 12/20/2020

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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