Care Management Community Coordinator

San Francisco Health Plan San Francisco , CA 94118

Posted 2 months ago

Overview

Are you ready to make an impact on the San Francisco community in a mission-critical, member facing role and help create systemic change?

The Care Management Community Coordinator (CMCC) will conduct in-person bio psychosocial assessments, create person-focused holistic care plans, and will function as a liaison, coordinating services among multiple providers and community agencies. This position will be based within the SFHP office but will involve substantial time in the community (at clinics and hospitals, with community-based organizations, and home visits). The CMCC will be responsible for managing members in the Health Homes program, a community-based program for a small subset of Medi-Cal members with complex psychosocial needs and high utilization of acute health services who require coordination at the highest levels. This will require attention to detail and the ability to adhere to workflows and documentation standards. The CMCC is expected to function independently in the field using mobile technology for regular communication with the team and should be comfortable with online clinical documentation.

This is a limited term employee position that will run through 2020.

WHAT YOU WILL DO

  • Conduct initial telephone or in-person assessments for members referred for care coordination services or case management, assessing medical history, psychosocial issues, resource needs, and level of function.

  • Develop member-centered, individualized Care Plans. Support the Care Management team with implementation of members' Care Plans:

  • Support members in identification of their own strengths and barriers to help them be successful with their Care Plans; respect members' health choices in the care planning process

  • Track access barriers and potential quality concerns, assisting members with grievances and escalating review in coordination with program leadership

  • Partner with member in navigating the system of providers and social service agencies

  • Support members and caregivers in re-assessment and modification of Care Plan goals

  • Help connect members to cultural, community, housing and social resources

  • Complete home visits, transport and accompany members to medical appointments, and outreach to members in the community including SROs, shelters and homeless encampments

  • Actively participate in SFHP meetings and trainings as needed

  • In conjunction with the CM nurse, support and educate individuals in: chronic condition management; medication management and adherence.

  • Provide referrals to mental health care; substance use management and treatment; transportation services and other health needs

  • Guide members through housing options; complete housing applications and provide advocacy for long term permanent housing for our homeless members

  • Initiate and participate in care conferences, ensuring the member's entire care teams participation

  • Coordinate care management activities with the assigned nurse and pharmacy staff, asking for input and consultation as needed

  • Coordinate with the nurse to complete the member's medical assessments and integrate the medical care plan goals

  • Complete all required documentation in a timely fashion in accordance with regulations, program standards and workflows

  • Maintain privacy and confidentiality practices in accordance with regulations and program standards

  • Act as a liaison to hospitals, long-term care settings, outpatient providers, home health representatives, and other community agencies

  • Attend and actively participate in regularly scheduled supervision meetings and communicate any concerns to the Supervisor as necessary

  • Represent the program to internal and external customers, working closely with member's PCP and care team

WHAT YOU WILL BRING

  • Minimum one year experience in community based outreach

  • Bi-cultural, bi-lingual language skills strongly preferred. Spanish, Cantonese, Vietnamese or Tagalog a plus.

  • Master's or Bachelor's Degree in a related field. Clinical supervision for MSWs may be available for up to 1200 hours.

  • Associate's degree, Certified Alcohol and Drug Abuse Counselor, or Community Health Worker certificates considered

  • Previous case management and outreach experience may be substituted for educational degrees

  • Experience working with people with mental illness, addiction issues, and/or homelessness

  • Experience with Medi-Cal and/or Department of Health Care Services regulations preferred

  • Proficient use of common Microsoft Word applications such as Word, Excel, Outlook and Access

  • Because this position requires member home visits, the incumbent must successfully complete a sex offender registry screen. May be required to pass additional background checks at agency discretion.

ABOUT US

Established in 1997, San Francisco Health Plan (SFHP) is a an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 145,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.

San Francisco Health Plan is an Equal Opportunity Employer (EOE) M/F/D/V

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Options


See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Cardiopulmonary Program Coordinator Pediatric Echocardiography (Ambul Care Admstn CRD 2)
New!

Ucsf Medical Center

Posted Today

VIEW JOBS 11/16/2018 12:00:00 AM 2019-02-14T00:00 At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve – a promise we share with the professionals who make up our team. Ranked by U.S. News & World Report as the number one hospital in California – and among the top six in the country – UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents. Department Description The Pediatric Echocardiography Laboratory uses echocardiograms a non-invasive test that uses sound waves to create a moving picture of the heart ¿ to evaluate and diagnose many different pediatric heart conditions. The laboratory also provides urgent and elective fetal echocardiograms from week 12 of pregnancy to full-term. Job Summary Under direct supervision and guided by the policies and procedures of Ambulatory Services, the Analyst is responsible for providing analytical support and daily administrative operations, including a broad scope of operational functions. The Practice Analyst must have the ability to perform and prioritize multiple tasks and work well with staff and faculty, in a complex environment. A high degree of independence, initiative, assertiveness, and diplomacy are necessary in daily practice. Analytical and practice support will be provided for the Cardiopulmonary practices by supporting the Pediatric Echocardiography/Fetal Laboratory, Pediatric Stress/EKG Laboratory, Pulmonary Function Laboratory, and other nursing/physician clinical support as needed. Responsibilities include daily operational management of the Cardiopulmonary Program which include gathering, organizing and interpreting data related to operational trends, deficiencies and identifying opportunities for the creation of plans and implementation, patient liaison and marketing work, compliance and quality assurance and APeX work queue management. S/he is knowledgeable about all aspects of the revenue cycle and scheduling, such as but not limited to: scheduling, registration, referral coordination, obtaining, verifying, and tracking of referrals, insurance authorizations as well as pricing and billing of services; and processing of charge capture for all departments mentioned above. The Practice Analyst must analyze and resolve billing problems, including working assigned reports to identify trends, resolve problems and ensure payment on accounts. The Practice Analyst must be knowledgeable about the patient registration system utilized at UCSF Medical Center. The Practice Analyst will have continual interaction with patients, sonographers, technicians, nurses and physicians, in person and by telephone, and must have strong interpersonal skills. Collaboration with management, cardiologists, nursing staff, sonographers and technicians to implement, monitor and maintain systems pertaining to all aspects of the patient's plan of care will be required on a daily basis. The incumbent is required to consistently project a professional and courteous demeanor and professional appearance. S/he is required to comply with the Medical Center House and Telephone Standards. This position may be required to cross cover divisions within Pediatric Specialties. Responsible for completing other duties as assigned. Required Qualifications * One to two years in an outpatient clinical environment working directly with patients and physicians * Associates degree in related area and / or equivalent experience / training * Knowledge of ambulatory care clinic practice management including patient care workflows and processes; demonstrated understanding of medical terminology and clinical knowledge of clinic practice area * Working knowledge of medical center policies and procedures and related legislative, accreditation, licensing and compliance environments * Strong communication skills; includes verbal, written and active listening; ability to clearly and concisely communicate clinic rules and regulations * Demonstrated interpersonal skills with diverse staff and patients; demonstrated ability to develop working relationships within clinical team * Proven organizational skills and the ability to effectively manage time and prioritize tasks; takes initiative; ability to meet tight deadlines and manage several projects simultaneously, respond rapidly to conflicting priorities, and handle tasks with high degree of accuracy * Ability to perform all commonly applicable functions in word processing and spreadsheet software; skills in data management; ability to use relevant healthcare and clinic operations information technology, including billing systems and medical record documentation * Data analysis, research, and reporting skills * Ability to demonstrate excellent attendance and reliability * Demonstrated ability to multi-task and be detailed oriented * Able to sit at a computer terminal and telephone for extended periods * Basic keyboard, computing skills and working knowledge of Microsoft Office applications to include Outlook, Word, Excel and PowerPoint * Functional knowledge and demonstrated use of APEX (Epic) and Microsoft Outlook as used at UCSF Medical Center * The flexibility to orient and work at all UCSF Medical Center locations Preferred Qualifications * Clinic experience * Experience with insurance verification, medical record abstraction, or patient financial services * Bi-lingual or multi-lingual capability (Spanish) Licensure/Certification * N/A Living Pride Standards Service Excellence * Demonstrates service excellence by following the Everyday PRIDE Guide with the UCSF Medical Center standards and expectations for communication and behavior. These standards and expectations convey specific behavior associated with the Medical Center's values: Professionalism, Respect, Integrity, Diversity and Excellence, and provide guidance on how we communicate with patients, visitors, faculty, staff, and students, virtually everyone, every day and with every encounter. These standards include, but are not limited to: personal appearance, acknowledging and greeting all patients and families, introductions using AIDET, managing up, service recovery, managing delays and expectations, phone standards, electronic communication, team work, cultural sensitivity and competency. * Uses effective communication skills with patients and staff; demonstrates proper telephone techniques and etiquette; acts as an escort to any patient or family member needing directions; shows sensitivity to differences of culture; demonstrates a positive and supportive manner in which patients / families/ colleagues perceive interactions as positive and supportive. Exhibits team work skills to positively acknowledge and recognize other colleagues, and uses personal experiences to model and teach Living PRIDE standards. * Exhibits tact and professionalism in difficult situations according to PRIDE Values and Practices * Demonstrates an understanding of and adheres to privacy, confidentiality, and security policies and procedures related to Protected Health Information (PHI) or other sensitive and personal information. * Demonstrates an understanding of and adheres to safety and infection control policies and procedures. * Assumes accountability for improving quality metrics associated with department/unit and meeting organizational/departmental targets. Work Environment * Keeps working areas neat, orderly and clutter-free, including the hallways. Adheres to cleaning processes and puts things back where they belong. Removes and reports broken equipment and furniture. * Picks up and disposes of any litter found throughout entire facility. * Posts flyers and posters in designated areas only; does not post on walls, doors or windows. * Knows where the Environment of Care Manual is kept in department; corrects or reports unsafe conditions to the appropriate departments. * Protects the physical environment and equipment from damage and theft. The flexibility to orient and work at all UCSF Medical Center locations is required. Equal Employment Opportunity The University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Further information about the University of California, San Francisco, is available at diversity.ucsf.edu. UCSF seeks candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence, and the communities we serve. Ucsf Medical Center San Francisco CA

Care Management Community Coordinator

San Francisco Health Plan