The Community Care Coordinator (CCC) works collaboratively with the health care team to manage and coordinate care for members that have social needs in order to ensure quality and cost-effective patient-centered care. This position also works directly with members/clients as well as with staff, managers, internal and external customers.

Duties and Responsibilities

Responsibilities include, but are not limited to, the following:

• Under the direction of a Medical Case Manager, performs ongoing care coordination activities. This includes:
  1. Conducting outreach
  2. Completing HRA and initial health screening
  3. Providing telephonic initial screen of non-medical needs, coordinates services and makes appropriate referrals
  4. Providing information to members/clients and/or their families regarding social and community support
  5. Assist with calls to various social service agencies as appropriate
  6. Off site visits (such as but not limited to home, hospital or community health centers or other community agencies) as necessary or required
  7. Supporting members to obtain access to care and services and making appointments
  8. Aid in obtaining medically necessary DME
  9. Directing members/clients to internal departments as appropriate
  10. Managing a case load of identified and/or assigned members
  11. Providing comprehensive documentation of all activities and contacts in CMAQE or appropriate software system
• Assist Medical and/or Integrated Care Managers in coordinating community resources as appropriate
• Participate in the development and maintenance of community resource database
• Calculate cost savings that may result from interventions, where an alternative level of care, service or resource has been identified and/or arranged
• Responsible for, identify, and, pursue opportunities for professional development
• Recommend and participate in the development of program improvements and QI activities
• Serve as resource to respond to questions from ancillary departments within Neighborhood
• Participate in community events and projects as assigned
• Provide cross coverage as assigned by Lead and/or Manager
• Participate in Outreach/Marketing activities as needed and appropriate
• Maintain up-to-date knowledge of resources in Rhode Island
• Other duties as assigned
• Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Qualifications

Required:

• Associates Degree in human service related field preferred or equivalent years of background and experience to equal degree
• Three (3) to Five (5) years experience in medical or social services setting or minimum of six (6) months experience working in a position at Neighborhood Health Plan of Rhode Island
• Experience working with the needs of individuals with behavioral health and/or long term care needs
• Strong oral and written communication skills
• Strong customer service orientation
• Strong interpersonal skills
• Strong organizational skills
• Ability to problem solve and work independently
• Strong collaborative skills and teamwork values
• Computer literacy with windows based programs
• Sound judgment
• Strong time management skills
• Ability to keep accurate records and prepare reports
• Ability to work with minimal supervision
• Flexible schedule including evenings and weekends
• Ability to travel for work, must have access to reliable transportation and/or valid drivers license and proof of insurance

Preferred:

• Clinical specialty experience
• Knowledge of community social service resources, State agencies and the state Medicaid program
• Knowledge of medical terminology
• Knowledge/expertise in substance use and/or mental health
• Bilingual

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.