Care Coordinator - Fitchburg, Massachusetts

CareSource/Commonwealth Care Alliance (CCA) is seeking a Care Coordinator in Massachusetts to serve as the primary point of contact for a stratified panel of members. This role assists enrollees in navigating their health care, providing care planning and coordination of services to ensure timely service delivery and continuity of care.

Responsibilities

• Serve as the first point of contact for enrollees, assisting with health plan processes, appeals, grievances, and removing barriers to needed services.
• Conduct routine outreach to members and providers to confirm service details and coordinate services with long-term services and supports teams.
• Act as a health plan subject matter expert and accurately document care coordination activities.
• Provide in-person visits to enrollees at least annually, with member consent.
• Maintain open lines of communication with enrollees based on their preferences.
• Ensure accurate and timely documentation in internal systems for visibility across teams and continuity of service.
• Coordinate provider and member scheduling, support high-volume outreach campaigns, and ensure task completion across multiple systems.
• Identify potential social support or community-based needs.
• Lead the interdisciplinary care team (ICT) for a stratified panel of members, collaborating with internal and external team members to create enrollee-centered care plans.
• Provide education on plan benefits and service options.
• Serve as a support resource for enrollees and providers, escalating concerns and ensuring issues are addressed promptly.
• Collaborate with clinical care managers, behavioral health clinicians, community health workers, providers, and external partners to ensure smooth communication and continuity of care.
• Gather and document service-related information during member interactions to support care coordination, service planning, or referral processes.
• Maintain accurate documentation of centralized enrollee records and ensure alignment with regulatory standards.
• Ensure enrollees follow up with providers, including assistance with appointment scheduling and verification of transportation.
• Facilitate communication and information exchange between members, their providers, and community supports.
• Perform other job-related duties as requested.

Requirements

• High School diploma or GED required.
• Two (2) years of experience in healthcare, customer service, or a related industry.
• Basic proficiency with Microsoft Office Suite (Outlook, Word, Excel).
• Knowledge of Medicaid, Medicare, and Managed Care is preferred.
• Exceptional listening, written, and verbal communication skills with a customer service focus.
• Professional phone etiquette.
• Ability to multitask using a variety of computer applications.
• Strong organizational and problem-solving skills with attention to detail.
• Ability to work independently and within a team environment.
• Understanding and support of the managed care concept.
• Adaptability to a constantly changing environment.
• Ability to type and talk simultaneously.

Licensure and Certification

• Must have a valid driver’s license, vehicle, and verifiable insurance. Employment is conditional pending successful clearance of a driver’s license record check.
• Annual Influenza vaccination is required (October 1 – March 31) as a condition of continued employment.

Working Conditions

• This is a mobile position requiring regular travel to different work locations, including homes, offices, or other public settings.
• Exposure to weather conditions typical of the location; may require standing or sitting for long periods.
• Must reside in the same territory assigned to work in; exceptions may be considered due to business need.
• May be required to travel greater than 50% of the time to perform work duties.
• Use of general office equipment such as telephone, photocopier, fax machine, and computer.
• Flexible hours, including possible evenings and/or weekends as needed to serve members.

Pay

$47,400.00 - $76,000.00 annually. CareSource considers a candidate’s education, training, and experience, as well as the position’s scope and complexity, when determining salary. In addition to base compensation, you may qualify for a bonus tied to company and individual performance.

Benefits

CareSource offers a substantial and comprehensive total rewards package focused on every employee’s total well-being.