### Role Overview
Join a dedicated team as a Clinical Care Coordinator, where you will be an integral part of managing a caseload of enrollees, ensuring they receive essential support and quality care. Your efforts will focus on coordinating care and maintaining effective communication between enrollees and their caregivers.
### Key Responsibilities
- **Caseload Management**: Ensure appropriate management of enrollees according to established Care Management Leadership guidelines.
- **Regular Contact**: Engage with enrollees based on their stratification level, providing consistent support as needed.
- **Face-to-Face Interactions**: Conduct in-person visits with enrollees and caregivers in settings such as their homes or healthcare facilities.
- **Needs Assessment**: Evaluate enrollee needs, barriers, and gaps during enrollment and at specified intervals.
- **Routine Care Management**: Perform care coordination activities while adhering to organization policies and national standards.
- **Collaboration**: Work alongside Senior Care Managers to review cases, set objectives, and assess potential care risks.
- **Documentation**: Accurately document interactions and findings in compliance with organizational policies while maintaining confidentiality.
- **Discharge Planning**: Contribute to discharge plans that consider the needs of enrollees and their families.
- **Education**: Inform enrollees and caregivers about EPSDT's importance and promote adherence to health services.
- **Follow-Up Care**: Review reports related to vendor services and facilitate necessary care follow-ups.
- **Referral and Transition Assistance**: Guide enrollees in transitioning between various care stages and refer them for appropriate services.
- **Authorization Management**: Enter approvals for services that require Care Management authorization.
- **Communication**: Foster an environment of effective communication with all stakeholders, ensuring clarity in both verbal and written forms.
- **Professional Conduct**: Maintain a professional demeanor while applying knowledge of medical terminology and healthcare delivery systems.
- **Time Management**: Demonstrate strong organizational skills under pressure while providing excellent customer service.
### Qualifications
- **Experience**: 3-5 years in managed care or care management, as well as clinical or community resource settings.
- **Communication Skills**: Proficient verbal and written communication skills; bilingual in Spanish is preferred.
- **Technical Proficiency**: Familiarity with medical terminology and Microsoft Office systems.
- **Organizational Ability**: Strong organizational skills and capability to interpret departmental requirements.
- **Decision-Making**: Sound judgment and decision-making skills with the ability to work under pressure.
- **Professional Meetings**: Experience in participating in multidisciplinary meetings.
### Licenses and Education
- **Licensure**: Licensed as a Social Worker (LICSW) or Registered Nurse (RN) in Washington, DC.
- **Certification**: Preferred case management certification.
- **Education**: An Associate's degree is required; a Bachelor's degree is preferred.
### Work Environment
- Expect moderate mental and visual stress, with regular computer use. Flexibility in working hours may be needed to accommodate member requirements, including some weekends and evenings.
### Diversity and Inclusion
We are an equal opportunity employer, committed to fostering a diverse work environment. We do not discriminate based on any protected characteristics and promote inclusivity across all aspects of our hiring and employment practices.
Employment Type: Full-Time