RN - Health Alliance Care Coordinator Specialist
Posted on: June 24, 2022
The Care Coordinator acts as the lead facilitator of the
multidisciplinary case management team and is a Registered Nurse
(RN). The focus of the role is managing and directing high-risk,
high-cost members to appropriate resources, services and programs.
In order to accomplish they evaluate and plan for comprehensive
coordination of care and health services to manage members across
the continuum. They partner and collaborate with the integrated
team and partners in order to provide seamless exchange of
information between providers, members, and caregivers with the
ultimate outcome to improve quality, reduce costs and enhance
- Manages both Medicare Advantage and Commercial members.
- Coordinates and manages complex medical cases and health care
needs across the continuum of care.
- Conducts member assessments, identifies gaps and interventions,
and coordinates ongoing care with physician and integrated
- Develops initial and quarterly personalized care plan with
member and the primary care provider (PCP).
- Maintains continuity of longitudinal documentation appropriate
for continuity of care.
- Helps the member create / coordinate a support team in their
local community to help them manage their long-term health status
- Tracks the top coordination tasks needed by most complex cases
and when they are completed will be graduating the member to
monitoring status and / or other programs.
- Lead facilitator of the multidisciplinary care coordinator team
managing and directing high-risk, high-cost members to appropriate
resources, services and programs.
- Care Coordinators will focus on 1% commercial and 5% Medicare
targeted/prioritized complex cases, subject to further
- Creates care plan summary and communicates / discusses with the
PCP and member.
- Assigned to embedded locations or geographic areas / service
Keywords: CARLE, Decatur , RN - Health Alliance Care Coordinator Specialist, Healthcare , Bethany, Illinois
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