The Care Coordinator provides administrative support to the care management team and facilitates access to health and community resources for members. They are responsible for conducting health risk assessments, documenting encounters, and coordinating care transitions to improve member health outcomes.
The Medical Director will lead the Medical Management Program and provide leadership for Health Management Teams. Responsibilities include supervising utilization and quality management, conducting clinical case reviews, and interacting with providers to ensure standards of care.
The Pharmacy Benefit Coordinator supports clinical outreach and HEDIS adherence initiatives to improve member healthcare outcomes and safety. They perform administrative tasks, manage pharmacy benefit implementation, and serve as a liaison between members, providers, and the PBM vendor.
