The Hospitals of Providence COORD, PATIENT CARE in Encino, California

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient communications, and value-based care solutions, we empower healthcare decision makers—hospitals, health systems, physicians, self-insured employers, and payers—to better connect every point of care and wellness management. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Our mission is to "improve Healthcare by increasing Healthcare quality and cost control through the effective deployment of information management and transaction efficiency.'"

Our vision is to provide "Global Support for Local Health Care." By following the principles of mutual respect for patients and families, our Nurses work with participants, providers, employers, health systems and hospitals, payers, professional advisors and communities to identify and coordinate the most appropriate services to address their healthcare needs.

Conifer Health Solutions is currently hiring for a Patient Care Coordinator in Encino, CA.

Position Summary:

This position will serve as a liaison between OneCare, One Care Connect (CalMediConnect) and SPD members, the PMG, CalOptima, medical providers, behavioral health providers and Long Term Support and Service (LTSS) providers. The PMG Personal Care Coordinator (PCC) will identify and reduce barriers to members’ care, assist the member in locating and accessing resources and educate the member on the importance of accessing care promptly. The PMG PCC will serve as the primary point of contact for the member and will be an integral part of the member’s interdisciplinary care team. The PMG PCC provides support to the member as they self-navigate the health care system. The PMG PCC works closely with member’s case management team to resolve access, medical and psychosocial related issues. This PMG PCC must be able to efficiently manage and prioritize a caseload of 400 members.

Degree of Supervision:

This position reports to the Ambulatory Case Management Supervisor. This position works under the direct supervision of a licensed clinical professional to ensure optimal coordination of care for the OneCare members requires moderate degree of supervision to ensure tasks are appropriately prioritized.

Job Duties and Essential Functions:

  1. Collaborates with CalOptima PCC to ensure timely communication of member’s clinical information.

  2. Effectively interview members to determine the client’s strengths, problems, functional status, goals and need for specific services/resources.

  3. Remain knowledgeable of OneCare’s benefit structure. Guide members in understanding and accessing the benefits they are entitled to under Medicare and Medi-Cal, through the OneCare program.

  4. Assist with coordination of member’s health care and social service needs both within and outside the Medical Group and CalOptima.

  5. Develop rapport, establish and maintain effective interpersonal relationships with internal and external contacts at all levels. Expedite the resolution of member and Provider concerns.

  6. Communicate effectively, both verbally and in writing with individuals from varying cultural and ethnic backgrounds. Knowledgeable principles and techniques to serve populations in diverse social and ethnic groups.

  7. Facilitate communication of initial care plan to the primary care physician (PCP), PMG CalOptima and member, as indicated.

  8. Assist member in meeting their preventive care goals (ie. HEDIS measures, Evidence Based Outcome Measure activities).

  9. Assist member with scheduling of appointments.

  10. In collaboration with clinician and Social Workers, facilitate referrals to LTSS, behavioral health and community resources.

  11. Initiate referrals to both internal and external care management departments and other department/government or community agencies

  12. Facilitate warm transfers to member’s assigned case manager or social worker in accordance with member needs, when appropriate.

  13. Notify member’s care team of key event triggers (ie. transitions of Care, falls, unsafe home)

  14. Outreach to members to complete assessment when there are changes to a member’s health status (i.e. key events)

  15. Assist in scheduling and participating in ICT meetings, as appropriate.

  16. Prompt communication of member’s case notes, HRA, care plan and interdisciplinary care team (ICT) proceedings to CalOptima’s PCC for integration in CalOptima’s medical management system.

  17. Maintain accurate records and documentation.

  18. Maintains and keeps in total confidence, all files, documents and records that pertain to the operation of business of Cap Management Systems.

  19. Attends all mandatory trainings

  20. All other job related duties as it relates to the job function or as delegated by the management team.

Educational Requirements:

  • Associate Degree or Bachelor’s preferred. High School diploma or GED may be considered if equivalent clinical experience documented. Medical Assistant preferred. Equivalent clinical work experience considered.

Experience/Skills Requirements:

  • One year Managed care experience (HMO, Medi-Cal/Medicare, Long Term Services and Supports and Community Health services) preferred. Experience in customer service. Preferably with proficient EzCap, Word, Excel computer skills. Excellent written and verbal communication skills. Problem solving and analytical skills. Ability to speak second language is preferred

Job: Conifer Health Solutions

Organization: Conifer Value Based Care


Location: CA-Encino

Requisition ID: 1605051107