Umpqua Health

Care Coordinator

• Provides comprehensive support for care management and care coordination activities for members enrolled in Medicaid and Medicare programs, including those receiving long-term services and support (LTSS) through waiver programs.
• Manages a caseload of members, conducts in-home assessments, and collaborates with a multidisciplinary team to ensure integrated, high-quality care across the continuum.
• Performs comprehensive member assessments, including face-to-face and in-home visits as required.
• Develops and implements individualized care plans in collaboration with members, caregivers, physicians, and support networks.
• Monitors care plans for effectiveness, documents interventions, and adjustments as needed.
• Promotes integration of services, including behavioral health, LTSS, and community resources.
• Evaluates benefits and advises on funding sources.
• Facilitates interdisciplinary care team (ICT) meetings and collaborates informally with team members.
• Uses motivational interviewing techniques to educate and support members.
• Identifies barriers to care and provides assistance to address psychosocial, financial, and medical concerns.
• Develops prevention plans for critical incidents to ensure member health and safety.
• Maintains accurate documentation in electronic systems and adheres to compliance standards.
• Travels locally (25–40%) for member visits; mileage reimbursement provided.