Care Worker

About the role

• Title: Care Worker
• Duration: 4+ Months (Possibility of extension)
• Location: CA Orange 92868

Shift: 8AM-430PM (could possibly need to fill in for the 1130AM-8PM shift as needed)

Requirements

• Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources.
• 1-2 years’ Experience in a managed care environment, integrated medical and behavioral health care and/or training in chronic pain management.

Job Summary

Facilitates department workflow by supporting clinical team with various care coordination workflows.

Locates community services and other referral locations for enrollees, arranges access to care, supports communication with hospitals, and providers.

Essential Functions

• Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotion.
• Trouble shoots when an appropriate provider, type of service, or appropriate level of care cannot be readily found.
• Has current knowledge or researches availability of community resources and services and link members to appropriate services.
• May assist in transitions in care for hospitalized patients and makes appropriate placements, if needed.
• Assumes responsibility for self-development and career progression.
• Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the Care Worker role.
• Assists in the mentoring and training of new Care Workers.
• Remains responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
• Coordinates and manages distribution of correspondence and materials to enrollees and providers.
• Participates in operational activities, including data collection, tracking, and analysis.

Additional Information

All your information will be kept confidential according to EEO guidelines.