Job Description

Location: Steward Medical Group - West
Posted Date: 8/28/2020

Steward Health Care is the largest private, tax-paying physician-led health care network in the United States. Headquartered in Dallas, Texas, Steward operates 35 hospitals in the United States and the country of Malta that regularly receive top awards for quality and safety. The company employs approximately 42,000 health care professionals. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, over 7,900 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.

The Steward Health Care Network includes 5,000 physicians across 800 communities who help to provide more than 12 million patient encounters per year. Steward Medical Group, the company's employed physician group, provides more than six million patient encounters per year. The Steward Hospital Group operates hospitals in Malta and nine states across the U.S., including Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah.

Position Summary:

The Care Coordinator is responsible for care coordination for members who require a comprehensive approach to immediate and/or ongoing care of their complicated and/or catastrophic medical illness. The Care Coordinator documents interactions with and on behalf of the member throughout service delivery including, but not limited to: care plans, progress notes, correspondences, and authorizations.

Key Responsibilities:

  • Identify patients who have had a recent transition of care and assist with follow up and discharge and/or further access to care needs.
  • Serve as the point person for various insurance companies to coordinate patients being seen in our offices.
  • Document the various quality measures (HEDIS, CQMs, Core Measures, etc.) that are missing for that patient’s medical condition or age at the direction of the Manager, Clinical Compliant and AVP-QI, Risk and Clinical Compliance.
  • Identify members through the reports from the health plans regarding those patients that are high utilizers of ERs or Urgent Care Centers and identify ways to decrease inappropriate utilization. Communicate with the patient the better option of calling our offices first, for non-life threating conditions.
  • Provide supportive services to patients when scheduling appointments, transportation, finding community resources and work collaboratively with the clinical care coordinator and/or case managers to support the patient’s care plan.
  • Consult Case and/or Disease Manager with the payer if the patient is in need of ongoing care coordination, at the direction of the primary care provider.
  • Help ensure that gaps in care, service and data collection are addressed.
  • Notifies the Manager, Clinical Compliance and/or AVP-QI, Risk and Clinical Compliance situations giving rise to clinical risk management issues (unsafe discharges, complications with care deliver, etc.)
  • Review the monthly ER report to identify those patients who have had high levels of ED utilization. Assist the primary care provider and/or Manager, Clinical Compliance to determine appropriateness those ED visits.
  • Educate patients and providers on services available to address chronic disease, chronic illness management or other identified reasons for utilization of the ER. If the face of the organization to providers in the community who might partner to care for patients.
  • Assist with outreach projects and chronic care improvement programs.
  • Attends required meetings.

Minimum Requirements:

  • High School Diploma or GED
  • Minimum of one (1) year in a managed care.
    • May accept clinic experience as a case manager.
  • Knowledge and experience with Microsoft Office products
  • Strong interpersonal, communication, and organizational skills
  • Strong organizational skills

Preferred Qualifications:

  • Clinical background
  • Three (3) to five (5) years’ experience interfacing with patients on care needs
  • Undergraduate degree

Benefits Offered

We have many plans with various deductibles, which can cover individuals or families so you can customize a plan that will work for you! Steward Health Care works with Blue Cross Blue Shield of Massachusetts to provide affordable health insurance for our employees. Our Health Plans Highlights are:

    • Deductibles will not apply to services provided by a Steward provider (Tier 1).
    • Office visits copays will be $0 when a member uses a Steward Provider (Tier 1).
    • Mental Health and Substance Abuse office visits will be $0 for all In-Network providers (Tier1, Tier 2, and Tier 3).

Other Benefits provided:

Dental, Vision, Health Care Savings Account, Life Insurance, Short Term and Long Term Disability, Tuition Reimbursement, Paid Time Off, and more.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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