Care Coordinator (Remote, US)

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Requirements:

• Minimum of 2-3 years of healthcare experience (e.g., roles like hospital administrator, medical assistant, CNA) or 2 years of Case Management.
• Knowledge of HIPAA regulations and other privacy laws.
• Ability to explain medical terminology and processes clearly to Members.
• Strong documentation skills, experience with Zendesk and IPS/Salesforce systems is a plus.
• Strong organizational skills and adaptability to a fast-paced environment.
• Commitment to exceptional customer service.
• Excellent verbal and written communication skills; fluency in English required, bilingual abilities are a plus.
• Ability to prioritize tasks based on urgency.
• Willingness to travel occasionally as needed.
• Legally authorized to work in the US.

Responsibilities:

• Screen Members for eligibility and refer qualified individuals for Care Coordination services.
• Coordinate patient care directly with healthcare providers and partnered vendors.
• Communicate with Members to address their requests and provide guidance.
• Keep Members updated throughout the Care Coordination process.
• Assist Members with the provider nomination process.
• Review high-risk calls with plan Members.
• Establish Letters of Agreement (LOA) or Single Case Agreements (SCA) with provider offices.
• Negotiate cash-pay rates with provider offices.
• Support patients on-site at the provider's office for 'on-the-spot case agreements'.
• Monitor and manage Member information, schedules, files, and forms.
• Represent Clearwater at conferences, training sessions, and other events as required.