Facilitates preventative and basic primary care to members, as needed, per CCA standard operating procedures, commonly accepted medical guidelines, and appropriate scope of
Provides regularly scheduled telephonic calls to support the management of chronic disease or end of life/
Assist the member with understanding their CCA Health Benefit package
Performs annual comprehensive telephonic assessments and coordinates any needed follow up from results
Coordinates a host of benefits such as transportation, LTSS, interpreter services, hospice services, and more.
Adheres to appropriate and complete documentation practices, including: history of present illness, adjustment or maintenance of an established treatment plan, and consistent follow up of the plan as evidenced in the
Performs episodic urgent medical/ behavioral health telephone calls and facilitates such visits are conducted in-person for applicable members on panel to ensure that timely and appropriate medical care in order to avoid emergency department visit or
Liaises with CCA interdisciplinary site team where applicable to ensure comprehensive member needs are consistently met
Manages panel-wide and member-specific utilization trends
Liaises with CCA and community-based PCPs/specialists
Collaborates with the Transitions of Care Team on all medical and psychiatric admissions to assist in discharge planning
Reviews approved authorizations to assess appropriate utilization, based on members' needs
Actively participates in the evaluation of own performance and progress
Participates in activities and education to maintain and advance competency
Participates in CCA quality improvement efforts
Seniority level
Entry level
Employment type
Other
Job function
Health Care Provider
Industries
Hospitals and Health Care
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