New

Care Coordinator (EPSDT) - Hybrid in Hampton Roads, VA

Sentara
life insurance, vision insurance, parental leave, paid time off, sick time
United States, Virginia, Norfolk
Nov 24, 2024
City/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health is seeking to hire a qualified individual to join our team as a Care Coordinator (EPSDT. Position Status: Full-time, Day Shift Position Location: Will work remotely some days and meet members at their home or out in the community Standard Working Hours: 8:00AM to 5:00PM Minimum Requirements: Associate's degree in Nursing preferred. Bachelor's degree in Health & Human Services-related field or related experience in lieu of education accepted. Licensed Practical Nurse (LPN) or Bachelor's prepared health professional strongly preferred MCO/HMO experience, 3 years of clinical experience within the last 5 years. 3 years of Medicaid/Medicare experience preferred. Familiar with HEDIS measures, EPSDT, and childhood immunizations charts and periodicity schedule. Utilization Management experience and Chart review/audit experience preferred. Job Description Summary Responsible for facilitation, implementation and coordination of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Member Outreach Program and overall compliance with immunization and EPSDT examinations. Serves as health plan resource for EPSDT/Well Child Program and all childhood exams, screenings, and vaccinations recommended by DMAS and per HEDIS measures. Responsible for data entry and monitoring of reports to increase utilization of EPSDT services. Maintains tracking system to identify new enrollees and children's non-compliance with EPSDT periodicity and immunization schedules. Ensures access to periodic preventive health care for members under the age of 21 years by promoting and coordinating child wellness in alignment with DMAS, health plan, and other professional organization initiatives. Conducts notifications of periodic screening requirements; develops educational materials and provides training to members/providers. Triages members with special healthcare needs (CSHN) using appropriate screening tools and assessments. Provides complex case management to members with complex needs. Performs related field work and community engagement travel as needed to increase EPSDT awareness and compliance. May assist with EPSDT policies/procedures and completing service authorizations. Diversity and Inclusion at Sentara Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve. We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community. We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done. Our strategies focus on bothstructural inclusion, which looks at our organizational structures, processes, and practices; as well asbehavioral inclusion, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all. Please visit the link below to learn more about Sentara's commitment to diversity and inclusion: https://www.sentara.com/aboutus/mission-vision-and-values/diversity.aspx SentaraOverview For more than a decade, Modern Healthcare magazine has ranked Sentara Healthcare as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals. Sentara Benefits As the third-largest employer in Virginia, Sentara Healthcare was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to: Medical, Dental, and Vision Insurance Paid Annual Leave, Sick Leave Flexible Spending Accounts Retirement funds with matching contribution Supplemental insurance policies, including legal, Life Insurance and AD&D among others Work Perks program including discounted movie and theme park tickets among other great deals Opportunities for further advancement within our organization Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within avibrant, creative, and highly productive workplace. For information about our employee benefits, please visit:Benefits - Sentara (sentaracareers.com) Join our team!We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth! *Note:* Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-beingin mind. Ourbenefits packages are designed to change with you by meeting yourneeds now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met. Job Summary Responsible for facilitation, implementation and coordination of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Member Outreach Program and overall compliance with immunization and EPSDT examinations. Serves as health plan resource for EPSDT/Well Child Program and all childhood exams, screenings, and vaccinations recommended by DMAS and per HEDIS measures. Responsible for data entry and monitoring of reports to increase utilization of EPSDT services. Maintains tracking system to identify new enrollees and children's non-compliance with EPSDT periodicity and immunization schedules. Ensures access to periodic preventive health care for members under the age of 21 years by promoting and coordinating child wellness in alignment with DMAS, health plan, and other professional organization initiatives. Conducts notifications of periodic screening requirements; develops educational materials and provides training to members/providers. Triages members with special healthcare needs (CSHN) using appropriate screening tools and assessments. Provides complex case management to members with complex needs. Performs related field work and community engagement travel as needed to increase EPSDT awareness and compliance. May assist with EPSDT policies/procedures and completing service authorizations. Associate's degree in Nursing preferred. Bachelor's degree in Health & Human Services-related field or related experience in lieu of education accepted. Licensed Practical Nurse (LPN) or Bachelor's prepared health professional strongly preferred. MCO/HMO experience, 3 years of clinical experience within the last 5 years. 3 years of Medicaid/Medicare experience preferred. Familiar with HEDIS measures, EPSDT, and childhood immunizations charts and periodicity schedule. Utilization Management experience and Chart review/audit experience preferred. Qualifications: ALD - Associate's Level Degree: Nursing, BLD - Bachelor's Level Degree: Healthcare Licensed Practical Nurse (LPN) Single State - Nursing License - North Carolina, Licensed Practical Nurse (LPN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP) Healthcare, Managed Care, Medicaid, Medicare Skills Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Judgment and Decision Making, Microsoft Office, Monitoring, Persuasion, Service Orientation, Social Perceptiveness, Time Management Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application. In support of our mission "to improve health every day," this is a tobacco-free environment.