Patient Care Coordinator

US-MI-Detroit
Req No.
2017-2210
Category
Operations
Type
Regular Full-Time

Overview

ConcertoHealth Inc. is the leading provider of specialized primary care and supporting clinical services for complex, frail, elderly, and dual-eligible patients. Operating exclusively in value-based agreements, ConcertoHealth provides high-touch, individualized care for patients, and deploys wraparound clinical resources to extend the reach of primary care practices. This comprehensive medical management solution, elevated by Concerto’s proprietary population health technology, improves overall healthcare quality and patient outcomes, benefiting payers and their provider networks.

Concerto delivers comprehensive care to Medicare, Medicaid, and complex-needs patients. The Concerto name reflects our unique approach to healthcare. It’s about how we work in concert with patients, providers, and health plans. Our approach focuses on bringing harmony across the spectrum of a patient’s care, health, and dignity.

 

The Patient Care Coordinator (PCC) is responsible for ensuring a positive experience for our members and providers. The PCC enhances the member’s experience by providing support to Care Managers in addressing member needs. This position collaborates with the Care Management team to provide quality care and services to members.

 

Position supports, MI, OH, IL, DSNP and MAPD

Responsibilities

Patient Care Coordinator (s) will support assigned Care Manager(s) with the following:

 

  • Schedule and Coordinate Level I Assessments, Integrated Care Team Meetings, Care Plan Updates and Transitions of Care Visits
  • Mail Unable to Reach and Integrated Care Team letters
  • Conduct research to locate member phone numbers, addresses, determine member’s PCP and document all efforts
  • Scan and upload IICSP Signature Page within 1 business day
  • Mail IICSP and Level I Assessment to Member and PCP within 1 business day of receiving request from Care Manager
  •  
  • Schedule appointments for members to see community PCP’s and Specialists within 2 business days of receiving request from Care Manager. Members who have a Concerto Provider will be warm transferred to the clinics Patient Service Representatives. Conduct follow-up calls to members to ensure appointment compliance and document efforts
  • Arrange transportation for members to get to/from appointments within 1 business day of receiving request. Efforts will be documented with confirmation number
  • Assist with member referrals for dental and vision services within 2 business days and document interventions
  • Assist members with locating a PCP and document efforts
  • Assist with Transition of Care Process (TOC), upon receiving inpatient notification calls will be conducted to confirm that members are still in the hospital. Efforts to reach members should be documented and communicated with the Care Manager for TOC process to begin
  • Assist with transitioning members by scheduling post discharge appointments with provider (s) and scheduling transportation within 1 business day of notification of discharge
  • Facilitate document collection from hospital and UM team to provide Case Manager with a comprehensive view of the patient’s inpatient experience and discharge orders within 72 hours of discharge.  
  • Follow up with members to ensure timely receipt of DME, supplies, and home health services within 1 business day of receiving request from Care Manager.
  • Assist Care Manager(s) and/or CM leadership with copying, faxing, and scanning of documents
  • Address Patient Care Coordinator Specific P3D Alerts
  • Provide support for BrightPattern phone queue
  • Assist with quality outreach campaigns as assigned
  • Track patient complaints and notify Manager to ensure resolution in a timely manner
  • Report any potential or identified quality of care issues to Manager to ensure an optimum patient experience with the goal of complete patient satisfaction and retention
  • Assist with field work, as assigned, for Unable to Reach population
  • Regular and consistent attendance
  • Maintain compliance with HIPAA, CMS, State regulations, and corporate policies and procedures
  • Complete all regulatory and required trainings
  • Other duties as assigned

Qualifications

  • High School Diploma or GED Required, Associate or BA/BS degree in Health Science or other health-related field preferred
  • 2 years of experience in a healthcare, patient oriented environment
  • 1 year of customer service experience
  • Demonstrated passion for extraordinary patient service
  • Demonstrate ability to multi-task in a fast-paced working environment.
  • Proficiency in Microsoft Office, Excel, and Outlook
  • Reliable transportation is required
  • Valid driver’s license and auto insurance is required

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