Integrated Duals Program Coordinator I

Job Summary:
The Integrated Duals Program Coordinator I supports care management activities by assisting assigned teams and ensuring timely service delivery and prompting continuity of care through coordinated outreach and engagement with members and providers. This role is responsible for conducting telephonic interactions, documenting service activities, and supporting coordination functions that enhance member satisfaction. Program coordinators also contribute to core operations including intake, triage, scheduling coordination, provider and member engagement, centralized documentation, and escalations.
Essential Functions:

• Understand and effectively demonstrate comprehensive person-centered thinking
• Conducts outreach to members and providers to confirm service details, coordinate scheduling, address general inquiries, and ensure accurate documentation of care coordination activities. Coordinate across diverse services by working with providers, community partners, and member/ caregivers to manage scheduling, service updates, and administrative changes, as needed
• Serves as a support resource for member and provider increase, request, escalations, or concerns by coordinating responses and ensuring issues are routed or addressed promptly
• Proactively identify and collaborate with care managers, providers, and other partners as needed to support member services and ensure smooth communication and continuity across care activities
• Monitor service delivery to ensure appropriateness of care and compliance with any waiver
• Gather and document service-related information during members interaction to support diverse specialty care coordination, service planning, or referral processes
• Maintain accurate documentation and maintenance of member records and alignment with regulatory standards, ensuring timely distribution to appropriate internal teams or provider partners as needed
• Follow established standards of practice, internal policies, and procedures to ensure compliance with contractual obligations and applicable regulatory requirements
• Identify member and provider needs and facilitate referrals to appropriate internal teams such as care management or community-based support programs
• Engage members through participating in information collection and assertive remote outreach to assist with comprehensive care coordination activities to support effective member outcomes
• Provide basic education to members and providers on available benefits and resources; escalates complex needs or urgent issues to the rapid response team for immediate follow up and coordination. Document care coordination activities and member response in a timely manner according to standards of practice and CareSource policies regarding professional documentation
• Look for ways to improve the process to make the members experience with CareSource easier and share with leadership to make it a standard, repeatable process
• Performs any other job related duties as requested.

Education and Experience:

• High School or GED required
• One (1) year of experience working in healthcare required
• Two (2) years of experience working in healthcare preferred

Competencies, Knowledge and Skills:

• Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
• Ability to communicate effectively with a diverse group of individuals
• Ability to multi-task and work independently within a team environment
• Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
• Strong advocate for members at all levels of care
• Strong understanding and respect of all cultures and demographic diversity
• Ability to interpret and implement current research findings
• Awareness of community & state support resources
• Critical listening and thinking skills
• Decision making and problem-solving skills
• Strong organizational and time management skills

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• May be required to work additional hours and/or outside normal business hours as needed to meet deadlines.
• Travel is not typically required

Compensation Range:

$41,200.00 - $66,000.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Hourly

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-TS1