At WelbeHealth, we make the impossible, possible for underserved seniors. We do this through utilizing and developing cutting-edge healthcare and well-being service products especially for seniors and their families. Now is your chance to join our talented team that delivers unparalleled creative healthcare, insurance, social support and more to seniors. We create senior well-being through our courage to love, pioneering spirit and shared intention. These values permeate everything we do. At WelbeHealth, you’ll help inspire that magic by enabling our teams to push the limits of healthcare and well-being experiences and create the never-before-seen!
Reporting to the Chief Medical Officer the Complex Care Coordinator is part of the central operations team. The Complex Care Coordinator is responsible for assisting the Nurse Case Manager with clinical case appeals, discharge planning and disease management. The Complex Care Coordinator provides assistance to the Case Manager in utilization management (such as prospective, concurrent, and retrospective review) to best meet the specific healthcare needs of participants and to promote quality and cost-effective outcomes and appropriate payment for services.
What you’ll do:
- Providing assistance to the case manager, faxing, paperwork
- Creating daily IP and SNF census with all needed information
- Updating IDT tracker and placing orders
- Responsible for obtaining prior authorizations for all services by successfully completing the authorization process with commercial payers. Contacts external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient’s stay and assists the treatment team in understanding the insurance company’s requirements for continued stay and discharge planning
- Complete all required documentation in a timely and accurate manner
- Protect privacy and maintain confidentiality of all company procedures and information about team members, participants, and families
- Communicate regularly with Supervisor and team regarding workload and priorities
- Exercises flexibility in performing assignments as business needs evolve
- Other duties as assigned
- Current MA Certificate. Preferred MA experience working in the Home Health/Clinical Setting.
- Valid State Driver’s License with a clean DMV record. Copy of recent Vehicle Insurance required
- High School Diploma or Equivalency
- Minimum of three years of Medical Assistant experience in a clinical setting with a frail or elderly population. Experience in a nursing home or hospital setting preferred
- Experience as care coordinator required
- Excellent clinical, organizational and communication skills in settings with seniors, their families and interdisciplinary team members
- Demonstrated ability to prioritize in a fast-paced environment
- Bilingual English/Spanish preferred
- Deep commitment to helping unlock the potential of our most vulnerable seniors
COVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all of our employees and proof of vaccination prior to employment is required.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.