Job Description:

Personal Care Coordinator 

Job Summary:

Sunshine Enterprise USA LLC we are looking for a Personal Care Coordinator (PCC) will be responsible for supporting members in completing their health risk assessment (HRA). This role will involve ensuring the communication of the member’s HRA and care plan with the member, Primary Care Provider (PCP), and the healthcare team. The incumbent will identify barriers to member’s care and assist in improving these barriers for all levels of care. The incumbent will work closely with the PCP and healthcare team to ensure member access to timely services and coordination of care.

Position Responsibilities:

·       Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability.

·       Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.

·       Performs outreach to members to coordinate completion of the initial and annual HRA, conducts telephonic and/or in-person HRAs as necessary, and ensures data entry of HRAs received via email.

·       Interviews members to determine strengths, problems, functional status, goals, and the need for specific services/resources.

·       Maintains documentation of member’s case, care plan, interventions, and interdisciplinary care team medical management system.

·       Collaborates with PCP and the healthcare team to ensure timely communication of member’s clinical information.

·       Partners with licensed professionals in the development of an initial care plan for each member, incorporating the HRA and all assessment findings.

·       Facilitates communication of the initial care plan to the PCP and member, as necessary.

·       Identifies the need for, and facilitates, referrals to Long Term Support Services (LTSS), Behavioral Health, and community resources.

·       Oversees warm transfers to member’s assigned Case Manager in accordance with member needs, when appropriate.

·       Works with Case Management staff to expedite the resolution of member concerns.

·       Guides members in understanding and accessing the benefits they are entitled to under Medi-Cal.

·       Notifies the member’s care team of key event triggers.

·       Maintains compliance with established departmental productivity guidelines.

·       Ensures reporting of productivity metrics to a supervisor as required.

·       Completes other projects and duties as assigned.

Possesses the Ability To:

·       Maintain accurate records and documentation.

·       Contribute to the development of a plan based on assessment of the member’s physical, psychosocial, functional, strengths/barriers, and mental health needs.

·       Establish and maintain effective working relationships with leadership and staff.

·       Communicate clearly and concisely, both orally and in writing with individuals from a diverse population.

·       Utilize computer and appropriate software (e.g., Microsoft Office: Excel, Outlook, PowerPoint, Word) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Experience & Education:

·       High School diploma or equivalent required.

·       1 year of experience working with the needs of seniors or persons with disabilities (SPD) in a customer/member service capacity required.

·       Bilingual in English and one defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese) required.

·       An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

·       Valid driver’s license and vehicle, or other approved means of transportation, an acceptable driving record, and current auto insurance will be required for work away from the primary office 20% of the time or more.

Preferred Qualification:

·       Bachelor’s degree in healthcare management or a related field.

·       1 year of Health Maintenance Organization (HMO), Medi-Cal, and/or health services experience.

Knowledge of:

·       Principles and practices of health care service delivery and managed care, Medi-Cal,

·       Long-term services and support.

Sunshine Enterprise USA is an “Equal Opportunity Employer—Minorities, Females, Veterans and Disabled Persons”