United States
1 month ago

Job Overview

Job Type
Full Time
Pay
Not disclosed

Job description

Location:
United States
Work arrangement:
Remote

Role Summary

As a Care Coordinator, you are responsible for providing care coordination for Medicaid, Medicare Advantage, and/or Dual Eligible Special Needs Plan (DSNP) members. You will create a positive experience for members by building trusted relationships with each member. This includes helping members access the right care at the right time with the health plan, providers, pharmacies, other vendors, and community-based organizations. You will assess and work with members to address both their medical and social needs (SDOH).

Ability To

Work effectively in a multi-cultural setting with a wide range of populations in a diverse community, while demonstrating knowledge and continued learning of the assigned community’s cultures and values.

Be an advocate for, support, and motivate members to manage their health and healthcare.

Maintain positive working relationships with members and their families, providers, and other external partners.

Build trust, actively listen, intentionally communicate, collaborate, and problem-solve.

Influence others toward positive outcomes.

Show passion for helping people improve their lives.

Move forward after setbacks or difficult interactions with members, using setbacks as learning opportunities for personal and professional growth.

Responsibilities

  • Conduct outreach to motivate, facilitate, and educate members about the benefits of programs.
  • Conduct assessments of the member’s status and develop a care plan with the member to address their goals. Assessments are conducted by telephone and/or text.
  • Evaluate individual member care needs and communicate medical information to health care professionals.
  • Manage a caseload of members to ensure expedient contact is made with each member.
  • Facilitate coordination of care with providers and schedule appointments as needed. Motivate members to be active and engaged participants in their health and overall well-being.
  • Identify and help address needs related to Social Determinants of Health.
  • Coordinate and complete correspondence according to established workflows.
  • Thoroughly and accurately document actions taken in a care management platform.
  • Make a high volume of outreaches to members, families, providers, or other recipients as needed to successfully perform the role.

Requirements

  • Active and unrestricted Licensed Vocational Nurse / License Practical Nurse (LVN/LPN) or Registered Nurse (RN) license
  • 2+ years experience as a care coordinator, case manager, community health worker, pharmacy technician, or social worker
  • Dedicated home office for remote work
  • 1+ years of remote work experience
  • Experience working with Medicaid and/or Dual Eligible patients
  • Strong interpersonal, communication (both verbal and written), and problem-solving skills
  • Experience working with customers over the phone and by text message
  • Experience with Apple computers (i.e., MacBook) preferred
  • Experience documenting case notes in a care management or electronic health record platform
  • Experience with motivational interviewing

Preferred

  • Bilingual fluency in Spanish
  • Post-discharge follow-up
  • Chronic Disease Management

Benefits

  • Competitive compensation packages
  • 401(k) with employer matching
  • Medical, dental, and vision insurance, including a 100% employer-paid option
  • Paid time off, paid sick time off, and paid holidays
  • 100% remote work from your dedicated home office
  • Comprehensive training and development
  • 100% employer-paid short-term disability, long-term disability, and basic life insurance
  • Health Savings Plan with employer contributions
  • Employee assistance program (EAP)
  • Full-time, Monday - Friday, 8:30am - 4:30pm CST
  • Work Location: Remote
Role:
Remote Care Coordinator Nurse
Job Type:
Full Time

Company profile

86Borders

86borders.com

86Borders is a human-first care coordination and member engagement company that partners with health plans to help members overcome obstacles to care, especially among hard-to-reach populations. Instead of relying on mass texts, voicemails or AI scripts, it builds trusted relationships that enhance member experience, improve health outcomes and simplify care navigation. 86Borders addresses barriers such as transportation, housing, language and confusing benefit systems, helping health plans advance their Star Ratings and other quality metrics.

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