Health Care Guide I

Job description

Overview In collaboration with Care Coordination team members, this position provides support and guidance to HealthPlan members referred to the Care Coordination Department for Case Management services and programs. The Health Care Guide I works closely with members, families, providers, community agencies, and the interdisciplinary care team to assist in coordination of benefits in a timely and cost-effective manner, while connecting members to available internal and external resources. Responsibilities: - Acts as the point of contact for members, families, providers, and/or community agencies calling into the Care Coordination Department requesting assistance and information about available PHC programs and information. - With direction, initiates and processes referrals to appropriate programs in accordance with department policies, and communicates referral outcomes to referral source. - Collaborates with members, families, providers, and/or community agencies to identify member needs and/or barriers. - Conducts targeted assessments to identify care coordination needs. - Researches appropriate and available PHC and/or community resources and provides guidance to member and int...