Managed Care Coordinator Green Card Jobs

INTRODUCTION

Sea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar proudly serves all persons without regard to race, ethnicity, immigration status, gender, or sexual orientation, and regardless of ability to pay for services. Sea Mar's network of services includes more than 90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social, and educational services. We are recruiting for the following position:

Sea Mar is a mandatory COVID-19 and flu vaccine organization.

Position Summary

The Managed Care Regional Coordinator’s responsibility is to ensure the accessibility and quality of Managed Care entry points at Sea Mar northern service sites. In addition to co supervision of Managed Care staff, they provide training, technical assistance and support to Managed Care Department staff. To maintain quality they conduct periodic staff competency testing and perform site audits to ensure compliance with corporate and departmental policies, standards and to maintain efficiencies. They assist in establishing and maintaining referral points connecting schools, faith based social service programs/agencies and business community to Sea Mar service sites. They serve as an advisor to clinic managers on public program changes, and staff performance audits. They assist the Managed Care Program Manager in the development and implementation of productivity and strategic marketing plans, tools, and evaluation processes to meet department goals and objectives.

Duties and Responsibilities

As a mission-driven organization, the core values of, and the services offered at Sea Mar are based on the belief that everyone deserves to be respectfully treated in a way that preserves dignity and enhances self-worth. Sea Mar is an advocate for its clients and aims to achieve industry-leading, client-centered, culturally-aware services.

Sea Mar employees serve as an extension of this mission and demonstrate their commitment to an excellent client experience by:

• Understanding and empathizing with client needs
• Surpassing client expectations
• Demonstrating a high level of integrity
• Exhibiting compassion and commitment
• Advocating for social justice
• Taking pride in individual work as well as that of the team
• Continually learning to stay current with industry standards, best practices and technology

As a Sea Mar employee, the individual in this position commits to adherence to these values to their utmost ability and endeavors to strengthen and embody this mission daily.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Under the direction of the Multicultural Services Director, the duties of this position include but are not limited to the following:

• Assists in the establishment and implementation of goals, objectives, policies, procedures for all operational areas of the Managed Care Department.
• Assists in strengthening and expanding new market areas promoting health coverage product awareness. Develops implements, and evaluates local and system wide strategic marketing plans.
• Assists in building a framework for marketing initiatives and devises marketing and PR campaigns to meet annual department goals and objectives.
• Responsible for assisting with new hire posting, coordinating interviews, selection, training, co-supervision, evaluation, and reports to the Multicultural Services Director problems involving staff disciplinary and termination actions.
• Monitors state policy and program changes impacting health coverage, or social programs, provide input on action steps and ensures that managed care staff and clinic managers are kept informed.
• Assess each MCD site to ensure that all managed care sites are properly staffed and supported with the appropriate information and tools. Conducts teleconference and or onsite meetings with Managed Care Department staff to trouble shoot and help refine processes to maximize efficiencies.
• Conducts staff performance and site audits to ensure compliance with department policy and procedures, and quality improvement guidelines.
• Establishes and reviews benchmarks that increase health care access. Collects, consolidates analyzes weekly and monthly production reports and submits weekly/monthly summary to the Multicultural Services Director.
• Collaborates with clinic managers to strategically implement marketing plans promoting Sea Mar programs, processes, products and services.
• Resolves problems, both administrative and operational and ensures compliance with corporate regulations and standards and maintains the strictest confidentiality and performs any other duties as may be assigned.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

• He/she will build trust, value others, communicate effectively, drive execution, foster innovation, focus on the customer, collaborate with others, solve problems creatively and demonstrate high integrity.
• This person must have exceptional organizational, and communication skills and demonstrate good judgment and excellent problem-solving abilities.
• At all times they must maintain a professional demeanor and exercise appropriate boundaries in all interactions.
• They must also have the ability to communicate clearly with individuals and before customer/community groups, Sea Mar employees and state agencies.
• This person must be able to understand policy, procedure and eligibility changes as reported in legislative bill text, Washington Administrative Code, and all other state publications. This knowledge must then be effectively communicated to the Sea Mar environment. In proposing new or adjusted systems in response to state-level changes, this person must demonstrate a comprehensive understanding of patient flow and consider impacts on all departments.
• Bilingual (English/ Spanish) required.
• Must be able to read and write proficiently in English and Spanish at a client and professional level.
• Also must be able to generate clear, concise reports, draft proposals, assist with grant writing and the ability to summarize data, and financial reports.
• Working knowledge and experience in a professional office setting, knowledgeable in the use of MS Office Word, Excel, Power Point and Publisher, as well as an overall proficiency in general computing skills.
• Must have the ability to add, subtract, multiply, divide, and average as it pertains to data utilization.
• Proof reading/editing and or graphic skills are considered a plus.

EDUCATION AND/OR EXPERIENCE

• B.A. degree either in health sciences, marketing, education or business is required with at least two years of experience in a managed care or health care related environment. Two additional years of direct managed care experience may substitute for formal education.

CERTIFICATES, LICENSES, REGISTRATIONS

• This person must have an initial TB test at hire and an annual retest and must receive a satisfactory background check from the Washington State Patrol.
• They must maintain a valid Washington Driver's license and automobile liability insurance coverage.

Additional Requirements

• The applicant must have an initial TB test at hire and an annual retest.
• Pre-hire and annual employee health screening required.
• Annual influenza vaccine required. Only exception is for employees with a medical or religious exemption approved by Administration. Employees with an approved medical or religious exemption must wear a mask at all time during the flu season.

Work Environment

The characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

This position may require working on weekends, or before or after the traditional working hours and requires travel to service sites to meet the full requirements of the job description.

Physical Requirements

The Managed Care Regional Coordinator will be required to stand for extended periods of time, lift heavy objects, and multi-task.

Compensation

• Hourly Plan: 31.25 USD Hourly

What We Offer:

Sea Mar offers talented and motivated people the opportunity to work in a dynamic and growing community health organization. Working at Sea Mar Community Health Centers is more than just a job, it’s a fulfilling career with opportunity for advancement. The fringe benefits surpass most companies. For example, Full-time employees working 30 hours or more, receive an excellent benefit package of:

• Medical
• Dental
• Vision
• Prescription coverage
• Life Insurance
• Long Term Disability
• EAP (Employee Assistance Program)
• Paid-time-off starting at 24 days per year + 10 paid Holidays.
• We also offer 401(k)/Retirement options and an exciting opportunity to work in a culturally diverse environment.

Sea Mar is an equal opportunity employer.