All Care To You

Manager

• Coordinate and oversee the care of patients receiving outpatient medical services.
• Identification of members appropriate for case management, based on identification of health-related problems.
• Assessing members physical and psychosocial needs/barrier.
• Developing the case management care plan.
• Developing and implementing the interventions needed to resolve barriers and coordinate care.
• Documenting assessments, care plan interventions, and all other activities related to coordinating the care of the case managed members.
• Maintain client privacy, safety, confidentiality, and advocacy while adhering to ethical, legal, regulatory and accreditation standards.
• Maintain department procedure/policy standards with regards to turnaround time, etc.
• Support the interdisciplinary team approach to ensure effective resource utilization, as well as quality and cost-effective outcomes.
• Coordinate resources for members.
• Document all case management activities in the Ezcap system.
• Utilize reports and systems to identify and monitor utilization patterns and facilitate needed care coordination.
• Attend Interdisciplinary meetings and team meetings.
• Manage the cases to include case management and transition of care activities.

Outpatient Case Manager

Customer Support

• Answer and filter all customer service calls.
• Make outbound calls to providers.
• Maintain customer service documentation, records, job aids, and policy and procedures.
• Resolve any grievances and complaints received through Customer Service, respond when needed to telephone and written inquiries and initiate steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims.
• Comply with all Company and Department Policies and Procedures.
• Maintain excellent customer service to all callers and staff.
• Assists other departments or with other projects as needed.

Customer Service Coordinator

Project Manager

• Manage All Care To You’s Compliance e-mail inbox and ensure timely completion of Compliance related deliverables
• Oversee and manage all aspects of a project from initiation to completion
• Define project scope, goals, deliverables, and timelines
• Create Azure tickets within the Compliance department with all required elements of the request
• Develop detailed project plans, including schedules, milestones, and resources
• Provide regular updates on project status to key stakeholders
• Document and update the status of all created Azure tickets
• Identify potential project risks and develop mitigation strategies
• Track and report on project performance using appropriate project management tools
• Conduct post-project reviews to assess success and identify areas for improvement.
• Assist with the development of Corrective Action Plans (CAPs) for regulatory agencies

Outpatient Case Manager

Customer Service Coordinator

Compliance Project Manager