Case Coordinator

• Collaborate and inform the case management process
• Facilitate appropriate healthcare outcomes for members
• Assist with appointment scheduling
• Identify and assist members with accessing benefits and education using care management tools and resources
• Evaluate members' needs, eligibility, benefit plans, and available programs or services
• Identify high-risk factors and service needs and refer to clinical case management or crisis intervention as appropriate
• Coordinate and implement assigned care plan activities and monitor progress
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
• Present cases at case conferences for multidisciplinary review
• Identify and escalate quality-of-care issues
• Negotiate appropriate options and services for members' benefits and healthcare needs
• Use influencing and motivational interviewing skills to promote member engagement and behavior changes
• Provide coaching, information, and support for independent medical and healthy lifestyle choices
• Engage in team meetings and provide peer mentoring/training
• Help members participate knowledgeably in healthcare decision-making
• Use case management and quality management processes in compliance with regulatory, accreditation, and company requirements

Case Management Coordinator – Field

• Conduct comprehensive evaluations of members’ needs and eligibility using care management tools and information/data review
• Recommend approaches to case resolution and meeting member needs by evaluating benefit plans and available programs/services
• Identify high-risk factors and service needs and refer members to clinical case management or crisis intervention as appropriate
• Coordinate and implement assigned care plan activities and monitor progress
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
• Present cases at case conferences for multidisciplinary review
• Identify and escalate quality-of-care issues through established channels
• Negotiate appropriate options and services for members’ benefits and healthcare needs
• Use influencing and motivational interviewing skills to engage members and promote lifestyle/behavior changes
• Provide coaching, information, and support to empower independent medical and healthy lifestyle choices
• Engage in team meetings and provide peer mentoring/training
• Help members participate knowledgeably with providers in healthcare decision-making
• Apply case management and quality management processes in compliance with regulatory, accreditation, and company requirements

• Facilitate appropriate healthcare outcomes for members through appointment scheduling, benefits access, and member education
• Evaluate member needs, eligibility, benefit plans, and available programs or services
• Identify high-risk factors and service needs, with referral to clinical case management or crisis intervention as appropriate
• Coordinate assigned care plan activities and monitor care plan progress
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
• Present cases at case conferences for multidisciplinary review
• Identify and escalate quality-of-care issues
• Negotiate appropriate options and services for members
• Use influencing and motivational interviewing skills to engage members and promote lifestyle or behavior changes
• Provide coaching, information, and support for independent medical and healthy lifestyle choices
• Participate in team meetings and provide peer mentoring/training
• Help members participate knowledgeably in healthcare decision-making
• Use case management and quality management processes in compliance with regulatory, accreditation, and company guidelines

• Collaborate with members, providers, and community organizations to address healthcare and social determinant needs
• Facilitate appropriate healthcare outcomes by assisting with appointment scheduling and access to benefits and member education
• Conduct comprehensive evaluations of referred members’ needs and eligibility using care management tools and data review
• Evaluate benefit plans and internal and external programs/services to recommend case-resolution approaches
• Identify high-risk factors and service needs, referring to clinical case management or crisis intervention as appropriate
• Coordinate and implement assigned care plan activities and monitor progress
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
• Present cases at case conferences for multidisciplinary review
• Identify and escalate quality-of-care issues through established channels
• Negotiate appropriate options and services to meet members’ benefits and healthcare needs
• Use motivational interviewing to promote member engagement, lifestyle, and behavior changes
• Provide coaching, information, and support for independent medical and healthy lifestyle choices
• Help members participate knowledgeably in healthcare decisions with providers
• Apply case management and quality management processes in compliance with regulatory, accreditation, and company requirements
• Interact with members/clients telephonically or in person, including possible visits to homes, worksites, or physicians’ offices