Care Extender - ECM Short-Term Assignment

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Quick Summary

Key Responsibilities

The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Requirements Summary

Not on a Performance Improvement Plan (PIP) Pro

Technical Tools

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Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the supervision of the Manager, Integrated Care Management, the Care Extender - ECM is responsible for working as the liaison for all incoming referrals for Enhanced Care Management (ECM) members. The Care Extender - ECM is responsible for skillfully engaging IEHP members who are transferred to the Care Extender queue, screening them for ECM eligibility, and referring over to the attributed Community Based Care Management Entity (CBCME). The Care Extender - ECM plays a critical role in determining appropriate routing of referrals within IEHP and the community to meet the members’ needs. The Care Extender - ECM will utilize multiple care management platforms to formally document the member’s disposition.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Responsibilities

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→Act as a subject matter expert resource for internal and external contacts supporting all Health Care Organizations. This includes:

→Assist Enhanced Care Management leadership with operational tasks, telephonic functions, projects, tracking, and trending.
→Facilitate communication between internal departments and external entities.
→Support Coordinators on Model 2 CBCME teams needing assistance.
→Provide training/precepting for new staff to IEHP and Enhanced Care Management processes and operations.

→Assist leadership with data collection, including Team Member metrics and process improvement initiatives

→Work as part of a multidisciplinary team to ensure coordinated and continuous care of members

→Perform initial outreach and engagement to Enhanced Care Management eligible members who have not been attributed to an Enhanced Care Management team.

→Identify the appropriate Community Based-Care Management Entities (CB-CME) for the member.

→Model the highest ethical behavior in relationships with co-workers, supervisors, members, Providers, and colleagues in the community.

→Promote a collaborative and effective working environment within the Enhanced Care Management team by engaging in evidence-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on member case discussions.

→Build and maintain positive working relationships with Providers, including, but not limited to, communication via in-person, over the phone, and through digital means such as email and fax.

→Engage with members by letter, email, texts, and telephone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the member and their medical/behavioral team, as well as to increase the member’s sense of control over their whole health.

→Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team.

→Assist with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services.

→Ensure documentation is accurate and in compliance with regulatory requirements and accreditation standards.

→Participate in Health Plan staff meetings or other activities as needed.

→Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Requirements

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Two (2) years of customer service experience in any setting required
Experience of successfully working within a team
Experience in data entry
Internal Candidate qualifications are:
- Not on a Performance Improvement Plan (PIP)
- Promotes an objective and collaborative working environment within their team
- Supports management in reaching department and Health Plan goals
High School diploma or GED required

Valid California Driver’s License preferred
Knowledgeable about evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies
Understanding of and sensitivity to multi-cultural community
Understanding of and sensitivity to mental health conditions and addictive disorders
Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both
Understanding of, and a commitment to, high preforming team practices
Strong organizational skills, typing 45 words per minute, proficient in Windows applications
Highly skilled interpersonally, with excellent teamwork and relationship skills
Highly skilled in interpersonal communication, including resolving conflict
Able to sufficiently engage members and providers both on the phone and in person
Has ability to deescalate escalated calls
Able to multi-task High degree of patience
Exhibits good Team Culture
Telephone courtesy
Demonstrated respect of peers and supervisors
Requires minimum supervision
Ability to take initiative and be proactive in competing tasks

Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)

USD $23.98 - USD $30.57 /Hr.