Care Coordinator

We need to output HTML fragment with sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. The posting includes "About The Role" (which is like description). Then "Primary Responsibilities" list. Then "Essential Qualifications". Then "About At Brighton Health Plan Solutions, LLC" (company description). Also there is mission, vision, DEI purpose statement. Those are more about company. The instructions: Use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). Do NOT repeat the job title as a heading. Do NOT put Job ID etc. Preserve ALL substantive information; do NOT invent or summarize away detail. Remove boilerplate, duplicated lines, application instructions. Include a section ONLY when posting has real, specific content for it — never emit heading followed by filler/placeholder text. Prefer few substantive sections over many thin ones. Thus we need to decide which sections to include. We have content for: - About the role: The first paragraph about MagnaCare and role description. That's substantive. - Responsibilities: The list under Primary Responsibilities. - Qualifications: The list under Essential Qualifications (includes education, experience, bilingual preferred, etc.) - Skills: Could be derived from qualifications? The posting mentions Superior oral and written communication skills, Strong PC skills (Excel is a must), Excellent organizational skills, Ability to maintain professional demeanor under pressure, Ability to work independently and as a team player, Strong skills in medical record review, Familiarity with medical terminology, etc. Those could be considered skills. But we already have Qualifications section; we could combine. However instructions: prefer few substantive sections over many thin ones. So maybe we have About the role, Responsibilities, Qualifications (which includes essential qualifications and skills). Could also include Benefits, Pay, Schedule if present. The posting does not mention benefits, pay, schedule. So we should not include those sections. Company description (About At Brighton Health Plan Solutions...) maybe could be considered "About the company" but not in allowed headings list. The allowed headings are About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. There's no "About the company". So we should not include that as a heading; maybe we can incorporate that content into About the role? But the instructions: "Use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It says e.g., implying those are examples but we could use other headings? Probably we should stick to those. The company description may be considered boilerplate? It's not exactly boilerplate but it's about the company. The instruction says remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The company description is not those; it's substantive. But we don't have a heading for it. Could we put it under About the role? Might be okay to include as a paragraph under About the role, as it's about the company but still relevant. However the About the role currently is about MagnaCare. The company description is about Brighton Health Plan Solutions. Might be considered separate but we could still include as part of About the role? Might be stretching. Alternatively, we could create a section "About the company" but not in allowed list; risk of being considered not following instruction. Better to incorporate into About the role as additional paragraph. Also there is mission, vision, DEI purpose statement. Those are also substantive but not fitting headings. Could be included under About the role as well. Thus final HTML:

About the role

... combined description ...

Responsibilities

... list items ...

Qualifications

... list items ...

We need to preserve all substantive information. Let's extract. About the role paragraph: "MagnaCare provides Utilization Review/ Case Management/ Medical Management/Claims Review services to its clients. Care Coordinators facilitate care management and utilization review by performing data collection & data entry, and effectively communicating with Nurse Case Reviewers/Managers, employers and claimants in regards to claimants’ workers’ compensation cases. Provide claims processing for the Workers’ Compensation and No Fault lines of business. The successful candidate will be afforded an opportunity to help further structure this team. This team is a critical component to the delivery of quality healthcare services." Then company description: "At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions. Come be a part of the Brightest Ideas in Healthcare™." Then mission/vision/DEI: "Company Mission Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners. Company Vision Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways. DEI Purpose Statement At BHPS, we encourage all team members to bring your authentic selves to work with all your unique abilities. We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace. We are building, nurturing, and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level. We are an Equal Opportunity Employer" We could include those as part of About the role paragraph(s). Might be long but okay. Responsibilities list: Let's extract each bullet: - Collect data from claimant representative, physician, or hospital; verify claimant case status and provider network status. - Set up cases in system in accordance with departmental workflows, policies and procedures. - Assist Nurse Case Reviewers with non-clinical issues tasks such as requesting clinical information from providers, obtaining necessary forms, and confirming work status - Enter required case demographics and transcribe clinical information - Handle incoming group phone calls and interact with employers, employees, physicians and insurance adjusters to gather information about medical status, and/or type of care needed in a timely manner - Schedule medical appointments for members with in-network facilities and providers and coordinate/verify member attendance at the appointment - Maintain and update all activity trackers within designated timeframes - Verify and ensure the accuracy of claimant cases; create, scan, fax, mail, and upload correspondence and documentation as needed. - Follow established quality assurance standards and all policies and procedures. - Report and document any concerns, complaints and/or issues with direct supervisor. - Demonstrates a kind, caring, sympathetic and positive attitude with all customers and fellow employees. - Perform Ad-Hoc projects and support departmental initiatives as needed We need to keep each as

. Qualifications list: Extract: - Superior oral and written communication skills - Strong PC skills (Excel is a must) - Excellent organizational skills - Ability to maintain professional demeanor under pressure - Ability to work independently and as a team player - Minimum of one years’ experience in the medical field - Bachelor's degree or equivalent experience - Bilingual preferred, but not required - Previous experience in case management handling insurance claims a plus. - Strong skills in medical record review. - Familiarity with medical terminology - Current knowledge of workers compensation and legislative issues a plus. We should keep as list. We should not include filler like "commensurate with experience" etc. Not present. We should not include Benefits, Pay, Schedule sections. Thus output HTML fragment. Make sure no extra markdown fences. Just raw HTML. Let's craft. We'll have:

About the role

MagnaCare provides Utilization Review/ Case Management/ Medical Management/Claims Review services to its clients. Care Coordinators facilitate care management and utilization review by performing data collection & data entry, and effectively communicating with Nurse Case Reviewers/Managers, employers and claimants in regards to claimants’ workers’ compensation cases. Provide claims processing for the Workers’ Compensation and No Fault lines of business. The successful candidate will be afforded an opportunity to help further structure this team. This team is a critical component to the delivery of quality healthcare services. At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions. Come be a part of the Brightest Ideas in Healthcare™. Company Mission: Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners. Company Vision: Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways. DEI Purpose Statement: At BHPS, we encourage all team members to bring your authentic selves to work with all your unique abilities. We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace. We are building, nurturing, and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level. We are an Equal Opportunity Employer.

Responsibilities

• Collect data from claimant representative, physician, or hospital; verify claimant case status and provider network status.
• Set up cases in system in accordance with departmental workflows, policies and procedures.
• Assist Nurse Case Reviewers with non-clinical issues tasks such as requesting clinical information from providers, obtaining necessary forms, and confirming work status
• Enter required case demographics and transcribe clinical information
• Handle incoming group phone calls and interact with employers, employees, physicians and insurance adjusters to gather information about medical status, and/or type of care needed in a timely manner
• Schedule medical appointments for members with in-network facilities and providers and coordinate/verify member attendance at the appointment
• Maintain and update all activity trackers within designated timeframes
• Verify and ensure the accuracy of claimant cases; create, scan, fax, mail, and upload correspondence and documentation as needed.
• Follow established quality assurance standards and all policies and procedures.
• Report and document any concerns, complaints and/or issues with direct supervisor.
• Demonstrates a kind, caring, sympathetic and positive attitude with all customers and fellow employees.
• Perform Ad-Hoc projects and support departmental initiatives as needed

Qualifications