AMBULATORY CARE COORDINATOR
Company: Network Medical Management Inc
Location: Monterey Park
Posted on: January 13, 2022
SUMMARYAssist Ambulatory Care Management Nurse with the
day-to-day care management responsibilities; to efficient and
effective ambulatory care management to eligible population.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Complies with NMM and department policies & procedures to
ensure all appropriate assessment for the eligible population are
completed and acted upon within established timeframes.
- Assist Ambulatory Care Management Nurse with day-to-day
- Responsible for data collection to assist ACM nurse with
assessment and care plan implementation but not limited to:
- Eligibility verification
- Create member chart
- Health plan portal data download (HRA, Member profile,
- Authorization/Claim history
- Request medical records from physicians for review.
- Create case (EZ-Cap/EZ-Care)
- Case load: Minimum 10 per day.
- Responsible for member/provider notification (telephonic and/or
written) utilizing department templates.
- Scan and file any applicable information to appropriate
- Scan and file returned member mailings to appropriate
- Notify ACM Nurse any change in members' status (unable to
reach, opt-out, agree to join)
- Responsible for follow-up call and returning department
- Participates in all health plan and department meetings and
trainings as applicable.
- Assist with health plan audit preparation.
- Maintains strictest confidentiality at all times.
- Performs other duties, projects and actions as assigned
- High School Graduate or equivalent
- Experienced in managed care environment to include but not
limited to health plan, IPA or MSO preferred.
- Knowledge of medical terminology, ICD-9, ICD-10, CPT
- Proficient with Microsoft Office (Word, Excel, Power Point) and
- Good organizational skills.
- Excellent written and oral communication skills, as well as
strong interpersonal, critical thinking and analytical skills.
- Must have the ability to multitask and problem solve in a fast
pace work environment
- Personal & Professional Qualities
- Punctuality, detail oriented, creativity, etc. would be helpful
for this position
- Ability to follow directions and perform work independently
according to department standards
- Able to function effectively under time constraint
- Able to maintain confidentiality at all times
- Willingness to accept responsibility and desire to learn new
- Must be a strong team player, punctual and have excellent
Keywords: Network Medical Management Inc, Monterey Park , AMBULATORY CARE COORDINATOR, Other , Monterey Park, California
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