The Care Coordinator facilitates a team approach to ensure appropriate interventions and cost effective delivery of quality care and services across the continuum. This role collaborates with an interdisciplinary care plan team to address care issues, specific member needs and disease processes. It coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes.
Collaborates with customer in creation of care plan and documents plan in medical management system. Partners with each customer to establish goals and interventions to meet the customer’s needs. Empowers customers with skills to enhance interaction with their providers. Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer. Tracks daily activities to trend volume and outcomes.
The Specialty and Retail Pharmacy Accreditation Program Coordinator ensures system-wide compliance with specialty and retail pharmacy accreditation standards. This includes planning, implementing, and coordinating accreditation compliance for all applicable accreditations including Utilization Review Accreditation Commission (URAC), Accreditation Commission for Health Care (ACHC) and others. The Coordinator is also responsible for ongoing readiness for accreditation surveys as well as regulatory complaint investigation.