Care Coordinator, SW DD – Hope

Empower Healthcare Solutions

. Oversee and facilitate the coordination of managed care services, including verifying eligibility, managing referrals, and obtaining authorizations for medical procedures, treatments, and services .

Posted 9/22/2026full-timeRemote • United StatesJunior💰 $1 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managed care services, including eligibility verification, referral management, and compliance with healthcare regulations. Proficient in delivering personalized health education and facilitating access to resources that address social determinants of health.

Highest-signal resume keywords

Managed Care PrinciplesHealth Insurance TerminologyUtilization ReviewOrganizational SkillsCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Eligibility VerificationReferral ManagementUtilization ReviewDocumentation MaintenanceProcess Improvement

Soft Skills

Interpersonal SkillsDetail-OrientedCollaboration

Tools & Technologies

Computer SystemsSoftware Applications

Certifications & Qualifications

High School DiplomaBachelor's Degree in Healthcare or Related Field

Industry Keywords

Managed Care ServicesSocial Determinants of HealthPatient AdvocacyQuality Improvement InitiativesHealthcare Regulations

About the role

Key responsibilities & impact

Oversee and facilitate the coordination of managed care services, including verifying eligibility, managing referrals, and obtaining authorizations for medical procedures, treatments, and services
Deliver personalized health education and coaching to members based on identified concerns outlined in treatment and service plan
Provide member support access in addressing social determinants of health, such as facilitating access to exercise opportunities and nutritious food
Verify insurance coverage and benefits for patients, ensuring accurate and up-to-date information is obtained and documented
Conduct utilization reviews to evaluate the medical necessity and appropriateness of requested services, ensuring compliance with established guidelines and policies
Collaborate with insurance companies and healthcare providers ensuring availability and quality of services
Facilitate coordination with diverse healthcare providers for diagnostics, ambulatory care, and hospital services
Serve as a point of contact for members, addressing their questions, concerns, and complaints related to managed care services, and advocating for their needs within the organization
Encourage initiatives aimed at improving the health of patients and their communities, including outreach efforts, quality improvement initiatives, and patient panel management
Coordinate community-based management of medication therapy
Ensure compliance with applicable laws, regulations, and contractual obligations related to managed care services
Maintain accurate and complete documentation of all interactions, authorizations, and communications
Ensure compliance with the PCSP and assist with any resources needed or barriers to accessing treatment
Identify opportunities for process improvement and efficiency enhancement in managed care operations
Propose and implement strategies to optimize service delivery and enhance patient satisfaction
Collaborate with both external and internal stakeholders to ensure the highest level of service efficiency

Requirements

What you’ll need

High School diploma and One (1) year experience in the mental health field
Bachelor's degree in a relevant field such as healthcare, social work, Psychology or social services and other healthcare related field preferred
Knowledge of managed care principles, processes, and regulations
Familiarity with health insurance terminology, coverage, and benefit structures
Strong organizational skills with the ability to manage multiple tasks simultaneously
Excellent communication and interpersonal skills to effectively collaborate with internal and external stakeholders
Detail-oriented and ability to maintain accurate records and documentation
Proficiency in using computer systems and software applications relevant to managed care operations
A valid driver's license and up to date automobile insurance must meet the minimum requirement in your state
Must be able to drive and perform quarterly visits to their members
Prolonged periods of sitting at a desk and working on a computer
The ability to occasionally lift objects weighing up to 15 pounds is required