Who we are:
Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.
We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.
Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.
A Day in the Life of a Care Coordinator:
This position coordinates care for populations enrolled in Meridian’s Care Coordination programs. This position must work with multidisciplinary care teams that may include: the member, the member’s PCP, specialists, social worker/behavioral health specialist and community resource contacts, while functioning with professional autonomy under the supervision of the Care Coordination leadership team.Responsibilities
- Manage an assigned caseload of Meridian members while remaining in compliance with all internal and regulatory requirements
- Create a relationship with the member working towards their optimal overall health and well-being by facilitating transitions of care for members through individual meetings in person and by phone
- Be the system navigator and point of contact for members and families, with members and families having direct access for asking questions and raising concerns
- Conduct complete, timely and accurate program specific assessments, including but not limited to, Health Risk Assessments, and prenatal and postnatal assessments, including current member demographic information
- Create and maintain strong communication with the members’ care team
- Develop and maintain a person-centered care plan for all members in assigned caseload involving the members PCP, family/caregiver, Social Worker/Behavioral Health specialists and other specialists as needed to evaluate the individuals’ needs, goals, and plan of action. Care plan activities can include but are not limited to:
- Establish a relationship between the member and a medical home, specialty care, mental health, etc.
- Provide education for members to address relevant healthcare issues with the goal of eventual self-management
- Identity community resource needs and connect member to services
- Collaborate with Utilization Management to ensure coordination and implementation of authorized services
- Assist members in problem solving potential access to care issues, such as need for transportation, interpreters, cultural resources, community resources etc.
- Address needed HEDIS with all members assigned and assist in scheduling appointments for HEDIS measure completion
- Complete all activities and interventions outlined in the members care plan and ongoing monitoring of cases to ensure routine follow up and progression in their care plan goals
- Responsible for answering all inbound calls received in the Care Coordination phone queue while maintaining all applicable service level standards
- Assist with training new Care Coordination staff on the Care Coordination Process
- Provide feedback to the leadership team on status of training and staff comprehension of the Care Coordination process
- Maintain HIPAA standards and confidentiality of protected health information; consistently demonstrate compliance with HIPAA regulations, professional conduct and ethical practice
- Make recommendations to leadership for process improvement
What you can bring to Meridian:
- Bachelor’s degree with a concentration in healthcare or related field or Fellow, Academy for Healthcare Management (AHM) Designation is required
- At least 6 months to one year experience in a clinical, mental health or managed care setting is required
Must demonstrate customer focused interpersonal skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, members, and families with diverse opinions, values, and religious and cultural ideals
Must also demonstrate the ability to work autonomously, follow through with delegated tasks and be directly accountable for deliverables
- Must have leadership qualities including time management, verbal and written communication skills, listening skills, problem solving and decision-making, priority setting, work delegation and work organization, as well as strong customer service focus, teamwork orientation and resourcefulness in problem solving
What Meridian can offer you:
- Our healthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members.
- Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
- Meridian offers 401k matching that is above the national average.
- Full-time Meridian employees are eligible for tuition reimbursement towards Bachelor’s or Master’s degrees.
- Meridian was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.
Equal Opportunity Employer