Coordinator - Enhanced Care Management (Hemet)

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the general supervision of the Enhanced Care Management Department Leadership, the Coordinator - Enhanced Care Management is responsible for working effectively with the integrated Enhanced Care Management team to facilitate and support Enhanced Care Management team activities. The coordinator is responsible for skillfully engaging IEHP Members, in order to enhance Member activation in their own health and wellness practices, as well as supporting the Enhanced Care Management team with administrative duties.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

• CalPERS retirement
• 457(b) option with a contribution match
• Generous paid time off- vacation, holidays, sick
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Paid life insurance for employees with additional options
• Short-term, and long-term disability options
• Pet care insurance
• Flexible Spending Account – Health Care/Childcare
• Wellness programs that promote a healthy work-life balance
• Career advancement opportunities and professional development
• Competitive salary with annual merit increase
• Team bonus opportunities

1. Responsible for working in an integrated team and assisting Members with care coordination needs, including, but not limited to, referrals for resources.
2. Responsible for assisting Members with outreach to find housing and assistance with tenancy services.
3. Responsible for assisting the Enhanced Care Management team with administrative duties needed for high functioning of an integrated team.
4. Model the highest ethical behavior in relationships with co-workers, supervisors, Members, Providers, and colleagues in the community.
5. Responsible for promoting a collaborative and effective working environment within the Enhanced Care Management team by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions.
6. Responsible for assisting the Nurse Care Manager and/or the Behavioral Health Care Manager with appropriate treatment plan implementation and coordination of care needs, as developed in collaboration with the Member, and consulting with the clinical Team Members before taking any action that is clinical in nature.
7. Responsible for building and maintaining a positive working relationship with Providers, including, but not limited to, communication via in-person, over the phone, and through digital means such as email and fax.
8. Responsible for engaging with Members, both in-person and on the phone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the Member and his or her medical/behavioral team, as well as to increase the Member’s sense of control over their whole health.
9. Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team.
10. Assists with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services.
11. Facilitate Member care to ensure that a continuity of care Letter of Agreement (LOA) is executed when appropriate.
12. Ensures documentations is accurate and in compliance with regulatory requirements and accreditation standards.
13. Participates in Health Plan staff meetings or other activities as needed.

Education & Requirements 

• Two (2) years customer service experience in any setting
  • Experience of successfully working within a team
  • Experience in data entry
  • Managed care setting experience preferred
• High school diploma or GED required
  • Associate's degree or Bachelor's degree from an accredited institution preferred
• Medical Assistant Certification or Certified Nursing Assistant preferred

Key Qualifications

• Must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
• Knowledge of Utilization Management including referral process, ICD-10 and CPT codes preferred
• Knowledgeable about evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies
• Understanding of and sensitivity to multi-cultural community
• Understanding of and sensitivity to mental health conditions and addictive disorders
• Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both
• Understanding of, and a commitment to, high preforming team practices
• Highly skilled interpersonally, with excellent teamwork and relationship skills
• Highly skilled in interpersonal communication, including resolving conflict
• Strong organizational skills, typing 45 words per minute, and proficient in Windows applications
• Able to sufficiently engage Members and providers both on the phone and in person. Telephone courtesy and high degree of patience
• Minimal physical activity; may include standing and repetitive motion
• Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership

Start your journey towards a thriving future with IEHP and apply TODAY!

Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)