Personal Care Coordinator – HRA Outreach (Bilingual)
Job Description
Department(s): Case Management
Reports to: Supervisor, Case Management
FLSA status: Non-Exempt
Salary Grade: C – $20.81 – $28.03 ($43,281 – $58,300)
About CalOptima Health
CalOptima Health is the single largest health plan in Orange County, serving 880,000 members, or one in four residents. Our motto — “Better. Together.” — is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community’s health. If you’re looking for an opportunity to work for an organization dedicated to improving local health care and serving the needs of the most vulnerable, we encourage you to join CalOptima Health.
About the Position
The Personal Care Coordinator (PCC) will support the members in completing their health risk assessment (HRA). The incumbent will ensure communication of the member’s HRA and care plan with the member, Primary Care Provider (PCP) and health care team. The incumbent will identify barriers to member’s care and assist in improving these barriers for all levels of care. The incumbent will work closely with the PCP and health care team to ensure member access to timely services and coordination of care.
Duties & Responsibilities:
• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Performs outreach to members to coordinate completion of the initial and annual HRA, conducts telephonic and/or in-person HRAs as necessary and ensures data entry of HRAs received via email.
• Interviews members to determine strengths, problems, functional status, goals and need for specific services/resources.
• Maintains documentation of member’s case, care plan, interventions, and interdisciplinary care team within CalOptima Health’s medical management system.
• Collaborates with PCP and health care team to ensure timely communication of member’s clinical information.
• Partners with licensed professionals in the development of an initial care plan for each member, incorporating the HRA and all assessment findings.
• Facilitates communication of initial care plan to the PCP and member, as necessary.
• Identifies the need for, and facilitates, referrals to Long Term Support Services (LTSS), Behavioral Health and community resources.
• Oversees warm transfers to member’s assigned Case Manager in accordance with member needs, when appropriate.
• Works with Case Management staff to expedite the resolution of member concerns.
• Guides members in understanding and accessing the benefits they are entitled to under Medi-Cal.
• Notifies member’s care team of key event triggers.
• Maintains compliance with established departmental productivity guidelines.
• Ensures reporting of productivity metrics to supervisor as required.
• Completes other projects and duties as assigned.
Experience & Education:
• High School degree or equivalent required.
• 1 year of experience working with the needs of seniors or persons with disabilities (SPD) in a customer/member service capacity required.
• Bilingual in English and one of CalOptima Health’s defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese) required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
• Valid driver’s license and vehicle, or other approved means of transportation, an acceptable driving record, and current auto insurance will be required for work away from the primary office 20% of the time or more.
Preferred Qualification:
• Bachelor’s degree in Healthcare Management or related field.
• 1 year of Health Maintenance Organization (HMO), Medi-Cal and/or health services experience.
Physical Demands and Work Environment:
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Physical demands: While performing duties of job, employee may need to move about the organization. Employee must be able to sit for extended periods of time, as well as work at the computer for long periods. Employee is required to use hands and fingers, especially for typing on the computer and using the mouse. Employee must be able to communicate, particularly for regular phone use and face-to-face interaction. Employee must have means of transportation to and from multiple locations during a work day. Must also be able to reach with hands and arms and must be able to lift and carry up to 25 pounds to transport laptop and other collateral material.
• Work Environment: Typical office environment with moderate noise levels and controlled office temperatures.
About our Benefits & Wellness options:
At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.
CalOptima is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima wants to have qualified employees in every job position. CalOptima prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.
If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.
Job Location: Orange, California
Position Type:
To apply, visit https://apptrkr.com/4302317
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