Job Summary:
The Women & Children’s Health Regional Coordinator will be responsible to identify, coordinate and support Medicaid School Programs, Schools, and School Based Health Centers to ensure CareSource children are receiving care needed.
Essential Functions:
- Develop and enhance CareSource relationships with MSP Schools, all other Schools, and School-Based Health Centers (SBHCs) with the goal of providing accessible quality preventive and primary care services to school-aged CareSource members.
- Develop partnerships with kindergarten readiness programs including Head Start, preschool programs and those community based organizations that support early childhood education.
- Assist MSP schools, all other Schools and SBHCs in identifying gaps in care and expected outcomes in the health status of targeted populations.
- Enhance effectiveness of MSP Schools, all other Schools and SBHCs’ population health through a variety of member health outcome and quality improvement techniques
- Strategize with MSP Schools, all other Schools and SBHCs to develop and enhance the practice’s engagement strategies for individual members..
- Attend school district meetings as appropriate including staff professional development programs and PTA meetings as requested.
- Ability to collaborate and coordinate health programs with schools and mobile health programs and identify new school support partners within the region assigned.
- Present to school staff and leadership regarding school-based health resources, member benefits and mobile health partner information to close gaps in care.
- Collaborate with community- based organizations that support school districts within the assigned region.
- Link MSP Schools and SBHCs to internal resources to ensure understanding of all operational and billing processes.
- Participate in driving and achieving established HEDIS initiatives as assigned.
- Support local presence by participating in community outreach programs/health events, school events, parent engagement programs, and other opportunities in the community.
- Identify and ensure members receive appropriate information regarding benefits and services upon notification of pregnancy (information regarding benefits for maternal, infants and children’s care including EPSDT).
- Assist in education of members regarding available benefits and providers, plan services available, according to established policies and procedures
- Telephonically outreach and engage members to identify needs and coordinate linkage to most appropriate resources and services(WIC, and Community programs)
- Assist members' progression through the stages of behavioral change, changing family dynamics and health care needs.
- Ability to empathize, motivate, and encourage people toward healthy changes, regardless of culture, religion, or economic background
- Refer members to care coordination to assist member in forming solutions for identified problem(s) area and define and determine realistic goals with member.
- Collaborate with internal School-based Health Administrator and Community Based Organizations to implement strategies and initiatives to improve health outcomes.
- Participate and collaborate to utilize community events and programs to support and improve health outcomes for school age children
- Assist in development and processing Strategic Sourcing request and process.
- Assist with process development, tracking of referrals, interventions, and outcomes
- Ability to communicate and interact with individuals at varying skill levels, educational and cultural backgrounds
- Foster and develop an environment of individual responsibility.
- Willingness to teach, learn and be open to new and innovative ways of delivering lifestyle prevention services.
- Demonstrates a commitment to continuing professional development
- May act as a resource for others within the department
- Work closely with a members’ assigned case manager to coordinate care and programs
- May provide administration of onsite wellness activities
- Perform any other job-related instructions, as requested
Education and Experience:
- Associate degree or equivalent years of experience within healthcare and/or school /children’s health is required
- Minimum of two (2) years of experience in healthcare, managed care and /or maternal-child health is required
Competencies, Knowledge and Skills:
- Ability to manage and meet workloads and deadlines
- Able to provide timely feedback to CareSource team members and business partners and prioritize provider and member engagement initiatives
- Intermediate proficiency level with Microsoft Office, Outlook, Word, and Excel
- Ability to communicate effectively with diverse population
- Ability to multi-task and work independently within a team environment
- Ability to collaborate with other internal team members to optimize birth and health outcomes for school-aged children
- Knowledge of community and state support and advocacy resources for population served
- Familiarity of state and federal healthcare regulations and environment
- Critical listening and thinking skills and willingness to be flexible
- Decision making and problem-solving skills
- Proper grammar use and phone etiquette
- Strong organizational and time management skills
- Ability to work within autonomous role, adapting and modifying plan of care of member as required
- Ability to work within web-based applications to manage consumer data
Licensure and Certification:
- Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated
- Employment is conditional pending successful clearance of a criminal background check
- To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
- CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
- Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
- Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members and may refer members to other CareSource resources
- WAH and/or Office Location
- May require travel up to 50% of time worked
Compensation Range:
$45,600.00 - $73,000.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Hourly
Organization Level Competencies
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer, including disability and veteran status. We are committed to a diverse and inclusive work environment.