Care Coordination Specialist - Roseville, CA - Remote

Summary

As a Telephone Service Center Care Coordinator Specialist at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Gainwell empowers you to help clients deliver better health and human services outcomes using innovative technology and solutions, enabling you to design your career for growth, new possibilities, and refinement of your valuable skills. Here are the details on this position.​

Your role in our mission

• Conduct assessments to identify individual member care needs and preferences to provide high-quality care coordination.
• Collaborate with members/legal representative, health plan, and providers, community-based organizations (CBO), interpreters and others in to aid members in accessing dental care. Work with members and providers to coordinate necessary dental care.
• Leverage a variety of resources, or combination of resources, to assist the member in coordinating care. Remove barriers to care such as assisting with appointments, transportation, language assistance. Identify members with special healthcare needs or other identified target populations that are eligible for case management.
• Monitor members are actively receiving appropriate care/scheduled care and complete their goals.
• Maintain and record decisions, actions, and outcomes for members receiving care coordination. Set up tasks, reminders and follow up on missed appointments.

What we're looking for

• A minimum of three (3) years of experience in a relevant Care Coordination position in the healthcare or insurance industry with Medicaid and/or Medicare knowledge and experience strongly desired.
• Medi-Cal Dental health experience is strongly preferred. Strong knowledge of dental treatment authorization request processes, procedures, and documentation is preferred. Strong knowledge of dental health management processes and procedures to include treatment documentation, record keeping, and chart narratives is required.
• Professional or personal experience supporting individuals with disabilities, chronic illnesses, or experiencing homelessness; including strong understanding of social determinants of health preferred.
• Familiarity with care coordination methodology and the ability to work independently and in a team setting.
• Education and experience:  High school diploma required. Clinical or administrative dental or medical experience required.  Registered Dental Assistant, Registered Dental Registered Dental Hygienist (RDH), Associate degree or equivalent in relevant field preferred.

What you should expect in this role

• Must be a resident of the state of California
• 100% remote within California
• #LI-REMOTE within California
• #LI-LS2