Case Management Coordinator

Primary Responsibilities/Accountabilities

• Initiate outreach efforts, both face-to-face and telephonically, related to targeted preventive health, care gaps, maternity, care transitions, health related social needs and chronic condition initiatives.
• Educate members on the importance of targeted preventive health services, assess opportunities for care management intervention, and make appropriate referrals, including referrals to community resources as needed.
• Contact members, providers, and community agencies to coordinate access to preventive health services and/or assistance to address health-related social needs.
• Identify member barriers, develop action plans, and engage in empowering interactions to guide members towards sustainable career paths.
• Serve as a subject matter expert in education and employment supports within the community.
• Develop a rapport with members, community-based organizations and provider partners to establish a supportive relationship which empowers members to take an active role in their health and wellness.
• Contribute to the development and preparation of educational materials for members and providers.
• Provide summary and outcomes of outreach attempts and community education to management and peers.
• Participate in the development of programs that are effective, measurable and innovative, with a special emphasis on reaching at-risk members.
• Conduct SDOH assessments as needed and assist with scheduling appointments, addressing social health barriers, and answering questions.
• Understand the Organization's lines of business and benefits for members in order to provide accurate and current information to members.
• Represent the company at community events, including events sponsored by community partners.

Qualifications

• A High School Diploma or GED
• One year of Community Health Worker experience or related field
• Lived experience in the community served
• Experience in Medicaid regulations
• Experience in customer service/member services within the healthcare sector
• Experience working with at-risk populations
• Certified Community Health Worker (CCHW) - PA Certification Board within 12 months of start date
• Preferred: Knowledge of principles and processes for providing customer service