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Care Coordinator - Hybrid
Job Number: 2024-46556
Category: Administrative Professional
Location: Shrewsbury, MA
Shift: Day
Exempt/Non-Exempt: Exempt
Business Unit: ForHealth Consulting
Department: ForHealth Consulting - Justice & Health Equity - W835110
Job Type: Full-Time
Salary Grade: 42
Union Code: Non Union Position -W60- Non Unit Professional
Num. Openings: 1
Post Date: July 27, 2024
Under the general supervision of the Manager, Care Coordination, this position is responsible for coordinating the medical access services of Justice Health & Equity (JHE). This includes communication and coordination with clinical and administrative staff of federal prisons, communication of schedules at multiple locations, scheduling of medical services delivered at the prison, managing critical data and maintaining automated databases, producing reports and documentation and providing education and support regarding security issues to staff and clinicians. All work is performed under strict contractual requirements.
This position performs complex and varied duties associated with the coordination of medical services for FBOP patients through the use of the JHE claims processing software as well as Teams, Word, Excel, Access, Adobe, EMR and Outlook applications. The Care Coordinator is the primary contact for the community-based provider network, interfacing between bureau providers requesting services and the provider network performing the services. This position makes complex decisions regarding protected healthcare information (PHI) based on the Federal regulations regarding the protection of health information under the Health Information Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.
Responsibilities
* Coordinates the complex scheduling of medical services for the Federal Bureau of Prisons (FBOP).
* Works remotely from the Federal Medical Center at Devens at least two days a week coordinating and running all aspects of assigned onsite specialty clinics.
* Acts as the primary point of contact for the Justice Health & Equity (JHE) contracted specialty provider for the assigned clinics.
* Prepares medical records for onsite specialty clinics.
* Utilizes Bureau of Prisons Electronic Medical Record (BEMR) to review consultation requests and create inmate patient schedule.
* Audits encounter forms as well as provider BEMR documentation for accuracy.
* Maintains proper boundaries when interacting with patients.
* Reviews daily written consultation requests/ medical referrals from the FBOP primary care team.
* Identifies problematic or incomplete consultation requests/medical referrals.
* Serves as the primary liaison between FBOP providers and community-based physicians.
* Collaborates with FBOP healthcare team communicating status of referrals.
* Provides the linkage between FBOP referring providers and community providers.
* Develops and maintains a system to request and retrieve medical record information.
* Reviews all medical referrals to ensure that an appropriate provider is chosen.
* Maintains the schedule for medical services provided at the prison.
* Maintains referrals/prior authorizations and patient appointments in the JHE claims management software.
* Independently develops and continuously delivers education regarding FBOP safety and security protocols.
* Makes complex decisions regarding privacy matters associated with the clients case.
* Corresponds and communicates daily with community providers and FBOP handling sensitive and confidential records/information.
* Ensures accurate appointment and scheduling information is entered into the JHE claims management system.
* Provides critical, highly sensitive scheduling and utilization reports.
* Addresses clients, providers, and agencies in an expert manner.
* Complies with established policies, health & safety regulations and requirements.
* Performs scanning functions, faxing, and other document management tasks.
* Monitors & evaluates all care coordination procedures and identifies areas for improvement.
* Performs other duties as assigned.
Minimum Requirements
* High School Diploma.
* 3 to 5 years of relevant complex office or direct healthcare experience.
* Demonstrated knowledge of medical terminology.
* Knowledge of HIPAA laws and regulations.
* Knowledge of Microsoft Office products.
* Ability to handle stressful and difficult situations in a calm and professional manner.
* Excellent verbal and written communication skills.
* Attention to detail, ability to prioritize and function independently.
* Position is contingent upon passing a background check from the Federal Bureau of Prisons.
Preferred Education and Experience
* Associates degree or some college in business or related field.
* Experience in a high functioning, multi-faceted, medical setting.
* Excellent communication and interpersonal skills.
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