Patient Care Coordinator

Candidate will be responsible for ensuring that appropriate member treatment plans are followed and proactively identifying ways to improve the health of our members and meet quality goals.

Candidate will be taking inbound calls on a phone queue from members and providers at the Florida Health plan. Additionally, associate will be processing pre-certification requests between calls.

Essential Functions:

• Coordinates follow-up care plan needs for members by scheduling needed appointments or enrolling member in related programs

• Assesses member compliance with medical treatment plans via telephone or through on-site visits

• Identifies barriers to compliance with plans and coordinates resolution to ensure that members receive appropriate level of care in a timely manner

• Researches data to identify opportunities to impact quality goals and makes appropriate process change recommendations

• Makes recommendations to adjust or modify treatment plan and determines need for additional services, in conjunction with case management and provider

• Coordinates identification of and referral to local, state or federally funded programs.

• Coaches members on ways to reduce health risks

• Prepares reports to document case and compliance updates; establishes and maintains relationships with agencies identified in appropriate contract