Company Description:

Clearlink Partners is an industry-leading clinical and operational consultancy, specializing in total cost of care that provides optimized end-to-end clinical and operational management programs for managed care organizations, health plans, providers and health systems. Through expert insights, innovative processes and comprehensive solutions, Clearlink helps healthcare companies improve enterprise-wide alignment and navigate a dynamic healthcare ecosystem.

Position Responsibilities:

Specific

• Gather and organize documentation to support care management process
• Review available information and interview patients to document needs and potential interventions
• Educate patients about their condition, medication, and available resources
• Provide input into the care planning process to address their personal health care needs
• Provide referrals and coordination to access available community resource programs and supports
• Consult and collaborate with other health care team members and specialists to set up patient appointments and treatment plans
• Check-in on the patient as designed, evaluate and document progress and coordinate progress with RN CM
• Assist the care team with developing and assessing effectiveness of healthcare interventions.

General

• Maintaining timely and effective internal and external communication regarding assigned work/ tasks
• Logging, tracking, and ensuring completion of all work in compliance with contract service standards
• Tracking review completion of assigned work to ensure final closure/ resolution
• Managing high workload volumes, ensuring accuracy and compliance with contractual deadlines
• Ensuring all necessary information is available and organized for professional staff review/ resolution
  • Outreach as necessary for clarification or collection of additional information needed
• Perform all job functions with a high degree of discretion and confidentiality in compliance with federal, company & departmental confidentiality guidelines

Position Qualifications:

• Excellent oral and written interpersonal/communication
• Strong internal/external customer-service, organizational, multitasking, and teamwork skills.
• Excellent analytical-thinking/problem-solving skills.
• Proficiency in Microsoft Office
• Ability to perform critical analysis and facilitate/ promote positive outcomes,
• Ability to work effectively in a fast-paced environment with multiple priorities, deadlines, and workloads.
• Ability to offer positive customer service to every internal and external customer

• 2+ years of experience work for a Managed Care (Payer)
• Experience with population health management, including care coordination practice in multiple lines of business (LOBs) including Medicare Advantage, Managed Medicaid, Dual SNP, & Commercial Lines of Business.
• LPN Preferred
• Knowledge of current access and care standards
• Knowledge of referral process for community resources and care coordination services
• Knowledge and competency with a variety of potential member needs, community resource availability and available support programs.

Other Information:

• Expected Hours of Work: Monday – Friday 8a.m. – 5 pm; with ability to adjust to Client schedules as needed
• Travel: May be required, as needed by Client
• Direct Reports: None

EEO Statement:

It is Clearlink Partners’ policy to provide equal employment opportunity to all employees and applicants without regard to race, sex, sexual orientation, color, creed, religion, national origin, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit-based factor in accordance with all applicable laws, directives and regulations of Federal, state and city entities.