AmeriHealth Hiring for Resource Coordinator at Georgetown, Delaware Full Time

*This is a remote field-based position requiring travel within Kent and Sussex counties.*

Responsibilities:

As part of the care coordination team, the Resource Coordinator supports the development of and executes on the outreach strategy in a certain territory for the purposes of influencing health outcomes and member engagement.  This position is responsible for establishing and cultivating relationships with members, community stakeholders and providers.  Responsibilities include, but are not limited to:

• Actively assisting providers in discharge planning for Level 1 members following acute episodes of care involving at a minimum one of the following services: inpatient psychiatric stay, ambulatory surgery, hospital inpatient stay, and rehabilitation facility services.
  • Assistance shall include but not be limited to: appointment setting, referrals and linkages to services, coordination of DME, and coordination of prior authorizations as needed to support the member’s timely access to services in the community
• Assist in closing social determinants of health and care gaps through appointment assistance, coordinating transportation, connection to community resources and wellness programs
• Establishes connection and acts as the primary ACFC contact to a targeted member population through home visits, community visits and outreach calls.
• Exercises judgment and discretion in the coordination of care by handling basic care follow up tasks and collaborating with AmeriHealth Caritas care coordination teams, community based health care providers, and other organizations. 
• Informs members of the required actions to fulfill HEDIS, EPSDT, and Plan requirements and other referred outreach, through phone calls or home visits, and encourages them to comply.
• Assists in addressing members’ barriers to care and to encourage/foster relationships with their medical/dental providers (medical/dental homes).

Education & Experience:

• 3 to 5 years experience in healthcare, human services, or community/behavioral health based care. 
• Associate’s Degree in Health Care, Human Services or a related field or equivalent work experience required. 
• Bachelor’s Degree preferred.
• Previous experience in presenting health education materials to individuals and small groups.
• Knowledge and understanding of medical terminology and disease processes.
• Ability to effectively communicate preventive health and health management philosophies to member’s and agencies.
• Comprehensive knowledge of Medicaid requirements and plan, policies and procedures.
• Knowledge of managed care.
• Candidate must possess a valid driver’s license and be willing and able to drive a car.
• Position will require 50% or more of travel time.