Company: Zolon Tech Solutions Inc.
Posted on: January 14, 2023
Title : HEDIS/Resource Coordinator Location : Newark, DE
Duration : 3+ Months Job Description:
- As part of the care coordination team, the Resource Coordinator
supports the development of and executes 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
- 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
- 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
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
Keywords: Zolon Tech Solutions Inc., Newark , HEDIS/Resource Coordinator, Other , Newark, Delaware
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