Virtual Care Coordinator – Pediatrics (Bilingual English/Spanish)

This is a remote position.

A pediatric practice in Dyer, Indiana, serving families across northwest Indiana. While they are a pediatric practice, they continue to see young adults age 20 and older, who can be seen by the family nurse practitioners. A significant share of patients are covered by Indiana Medicaid, and many of families prefer to communicate in Spanish.

We are looking for a bilingual (English/Spanish), pediatric-experienced virtual assistant with excellent customer service and communication skills to own three ongoing workflows: working our well-visit scheduling task queue so every child stays on track with their well exams; coordinating the Centene Continuity of Care Plus (CoC+) program for our MHS (Medicaid) and Ambetter (Marketplace) patients; and closing care gaps for our other Medicaid plans and other payer populations.

This person will work closely with our providers and in-office staff and will be a primary point of contact for parents and caregivers, in English and in Spanish.

Responsibilities include, but are not limited to, the following:

Well-Visit Scheduling

Work only the well-visit scheduling tasks in our scheduling queue. The queue also contains other scheduling task types, and patients may have other visit types scheduled (sick, follow-up, etc.). Leave other task types alone unless otherwise assigned.

Work the queue.

Go to Tasks → Scheduling and use the Due / Overdue / Upcoming filters, sorting by Priority when needed.

Review history first. Open each task and review the Activity tab/history before taking action to see prior outreach, cancellations, or recall activity.

Cancel the task only when the well visit is handled.  Cancel the well-visit task you are working on only if one of the following is true:

The patient is already scheduled for a well visit. A scheduled sick, follow-up, or other visit does not count.

The patient already had the well visit for their current age, and a well-visit scheduling task for the next age-appropriate well visit is already in place. Without that next task, the family will not receive a reminder when the next visit is due, so make sure it exists before canceling.

If neither is true, keep the task open and schedule the well visit.

Schedule patients who are due.  If the well visit is due and no well visit is scheduled, reach out by phone, portal, or text using the task.

Patients under 18: Contact the parent or caregiver.

Patients 18 and older: Contact the patient directly.

Patients under 21 may be scheduled with the provider of their choice.

Patients 21 and older must be scheduled with Nicole or Ken (our family nurse practitioners).

Keep recalls clean.  Recall reminders are tied to the linked scheduling order/task, so resolve or cancel outdated items once the patient is scheduled or no longer needs the task.

Continuity of Care Plus (CoC+) Program Coordination

CoC+ is a Centene program for MHS (Indiana Medicaid) and Ambetter patients. The plan pre-selects eligible patients and provides an Appointment Agenda for each one, listing items for the provider to review at a visit (risk adjustment conditions, high-complexity/ER activity, quality care gaps, clinical coordination, and drivers of health).

The practice is paid for each fully completed agenda that is backed by a matching claim, with higher payment for electronic submission and for reaching 80% completion.

Patient Outreach & Scheduling

Pull the eligible-patient list from the MHS Secure Provider Portal (Care and Risk Gaps – Daily View → Centene Clinical Action → CoC+) and export it for tracking.

Match eligible patients against upcoming appointments.

Contact eligible patients who don’t have a visit yet this year and schedule them by phone and/or text.

Check the list monthly, since agenda items are updated monthly.

Visit Preparation

Pull the agenda as early as possible, before each eligible patient’s visit.

Upload the agenda to the patient’s chart.

Add a CoC+ alert pop-up to the chart so in-office staff know the agenda must be printed and completed at the visit.

After the Visit

Receive the completed agenda from in-office staff (the provider completes the agenda and documents in the chart during the visit).

Confirm every item on the agenda has a response. One missed item disqualifies the agenda.

Enter the provider’s documented agenda responses, including diagnoses, into the portal exactly as documented, and flag anything unclear to our team rather than guessing.

Submit the agenda electronically through the portal (electronic submission pays double the paper rate).

Track completion percentage by provider, with a goal of 80% or higher.

Key deadline: All 2026 agendas must be submitted by January 31, 2027.

Care Gap Closure – Other Medicaid Plans & Payers

Pull care-gap reports and patient lists from other Medicaid managed care plans and other payers through their provider portals.

Contact families of patients with open care gaps and schedule the needed visits or services by phone and/or text.

Flag open care gaps in the patient’s chart ahead of scheduled visits so providers can address them.

Track open and closed care gaps by payer and follow up on gaps that remain open.

Support quality programs (HEDIS), including assisting with pulling and submitting medical record documentation for HEDIS reporting (seasonal).

General

Document all outreach attempts and outcomes in the chart or task.

Communicate with providers, in-office staff, and billing staff about scheduling needs, incomplete agendas, and anything that needs billing follow-up.

Other scheduling and care-coordination tasks as assigned.

What Success Looks Like

After the initial clean-up, keeping the well-visit task queue up to date so families get timely reminders.

Making sure each patient has their next well visit scheduled or a reminder in place.

Completing CoC+ agendas for as many eligible patients as possible, ideally submitted electronically and ahead of the January 31, 2027 deadline.

Closing care gaps so our patients receive the preventive care they need.

Building warm, trusting relationships with our English- and Spanish-speaking families.

Requirements

What We Are Looking For

Required

Bilingual English/Spanish (fluent spoken and written). Must be comfortable calling, texting, and

messaging parents and caregivers in either language.

Excellent customer service skills. Warm, patient, and professional with parents and caregivers, including during difficult or time-sensitive conversations.

Strong communication skills (spoken and written English). Clear and courteous by phone, text, and patient portal, and able to communicate effectively with providers and in-office staff.

Pediatric experience in a pediatric practice or pediatric care coordination role. Must understand age-based well-child visits and why keeping children on schedule matters.

Experience with EHR task queues and scheduling, including reviewing patient history before taking action.

HIPAA-trained and careful with protected health information.

Highly detail-oriented. Several of our workflows fail if a single step or checkbox is missed.

Available to work during our office hours (Central Time).

Preferred

Pediatric nursing background, or a comparable pediatric clinical role.

Familiarity with U.S. health insurance, especially Medicaid managed care plans and payer portals.

Working knowledge of medical coding: ICD-10, CPT, CPT II, and HCPCS.

•Experience closing care gaps for Medicaid and other payer populations, including risk adjustment.

Experience navigating payer provider portals to pull care-gap reports and patient lists.

Benefits