Care Management Coordinator

DaVita Medical Group - Los Angeles, CA3.3

Responsible for providing administrative support for the Care Management team and Hospitalists to prevent and reduce readmissions by ensuring patients are supported in the transition from inpatient back to outpatient setting.

Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
Interacts with contracted facilities’ Care Managers regarding patient discharge planning and post-hospital follow up care.
Arranges home health care and DME services for patients discharged from hospitals and SNF’s.
Conducts patient survey after discharge to determine if discharge plan is completed and any additional patient needs are required (medication instruction or intervention with physician / care manager) to prevent re-hospitalization.
Engages in patient advocacy, empowers patients to take charge or leadership in their healthcare and coaches patients to ask questions to understand their disease process and treatment plan.
Works in collaboration with the Care Manager / Care Navigator to support and coach patients through identifying or recommending in-house, community-based assistance or support programs to help meet patient goals.
Confirms patient’s understanding of treatment plan by reviewing information PCP / specialist shared with patient.
Ensures patient was given all pertinent data including but not limited to: active medication list, patient instruction sheets, copies of lab results and last physician note or treatment summary.
Serves as a liaison between patient and clinician to encourage patient’s engagement in “Life Planning”.
Identifies patient complaints or issues that must be reported to appropriate person (i.e. clinician, Patient Liaison, Social Worker, Care Manager / Care Navigator or supervisor).
Collaborates with hospital and SNF staff in order to obtain daily census and discharge summaries.
Provides and receives ongoing follow up information and collaborates with PCP and ancillary staff to meet patient goals.
Assists with obtaining discharge records and test results from hospitals or out of area facilities and distributes them to PCP’s and specialists.
Utilizes systems (K2 / SharePoint) to manage daily activities and for tracking and reporting purposes.
Participates in making tuck-in phone calls to target population as directed.
Processes monthly custodial patients including calling SNF to determine if patient is custodial and update authorization.
Utilizes tasking function in TouchWorks to communicate with Care Managers and PCP’s.
Checks patient’s eligibility using IDX, HCP Connect or health plan website.
Utilizes IDX for Group PCP scheduling and entering inpatient authorizations.
Utilizes HCP Connect to enter authorizations for DME, home health and transportation.
Uses health plan websites to obtain patient benefit information.
Updates and maintains daily census using Patient Keeper system.
Contact patient at hospital and home to coordinate and reschedule PCP and specialist appointments.
Works with PCP office to schedule patient appointments and schedules PCP and specialist follow-up appointments as directed by the Care Manager.
Processes follow up emergency care requests from Patient Support Center department.
Participates in regional and hospital pilot projects.
Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Performs additional duties as assigned.

1 or 2 years of post-high school education or a degree from a two-year college.
Graduate from an accredited Medical Assistant program preferred.

Over 1 year and up to and including 3 years of experience in the healthcare industry.
Over 2 years of customer service experience in a healthcare environment.

2 or more years of experience in a healthcare setting.
Call center experience.

Computer literate.
Proficient in MS Office and web browsing.
Ability to work alternating shifts, 7 days a week, as needed.
Strong data entry skills with ability to type 40 wpm.
Basic clerical skills (telephone, e-mail, fax).
Multi-line telephone experience with excellent telephone etiquette.
Excellent verbal and written communication skills with the ability to read, write, speak and understand English clearly.
Customer service-oriented.
Excellent problem solving skills.
Organized and detail-oriented.
Ability to concurrently perform multiple tasks.
Health literacy and cultural awareness skills.
Basic medical terminology coding (advanced preferred).
Ability to resolve conflicts for patients and their families.
Ability to transfer knowledge to patients with diverse cultural backgrounds while managing their care.
Ability to use health information technology resources in patient management.
Psychosocial and social support awareness.
Motivational interviewing skills.
Ability to maintain composure in a challenging situation.
Ability to interface with all levels of management.
Ability to adapt to changing duties and work in a fast-paced environment.
Bilingual in English and Spanish.
What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(SM)

Careers with OptumCare. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. OptumCare, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)

Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.