Care Coord IHPA Outreach

The Care Coordinator will be Trilogy’s clinical liaison to managed care organizations (MCOs), Integrated Health Homes (IHH), The Illinois Health Practice Alliance (IHPA), and will ensure compliance with The Healthcare Effectiveness Data and Information Set (HEDIS) measures.  They will work directly with contracted MCOs to find, engage, assess, and connect members to necessary healthcare needs.  They will monitor and report on metrics and outcomes.  They will work with departments and programs across the organization to ensure care coordination standards are met.  The Care Coordinator will provide and ensure the team provides client-centered, strengths-based, and trauma-informed services to clients with severe mental illness and co-occurring substance abuse/addiction disorders utilizing a harm reduction approach.  

Responsibilities


* Liaison between Trilogy and MCOs to locate members disconnected with MCOs and treatment.  Engage, assess, and connect them to necessary health care (e.g.

review of claims if available)


* Prioritize clients in potential need of community-based care coordination with MCOs


* Conduct health assessments related to member’s ’s personal, medical, emotional, social, and environmental situation and make referrals to appropriate levels of care.


* Contact identified members to provide education on programs that will address their healthcare needs linking them to needed community services.  Engage members in discussion of adherence to personal health plans. 


* Organize and direct care coordination efforts across departments and programs


* Develop and maintain positive working relationships with partner organizations in Trilogy’s Prime, MCO’s, IHPA, and IHH


* Meet deliverables based on MCO care coordination contracts and complete required reporting.


* Attend inter-department team meetings as needed to gather information for care coordination purposes and ensure high quality service for clients


* Develop, implement, and track HEDIS measures across the organization.


* Maintain prior authorization, documentation, and ensure charting is in compliance with MCOs, Medicaid, state specific accreditation, and organization standards.


* Perform other job-related duties and/or projects as assigned.

Qualifications


* Master’s Degree in Social Work, Psychology, or Counseling required


* IM+CANS certification required or must obtain IM+CANS certification within 30 days of hire date.


* Minimum one year of experience working with people with mental health and/or substance abuse diagnoses


* Valid Illinois driver’s license with daily access to a well-maintained vehicle with $100,000/$300,,000 liability insurance


* Licensed Clinical Social Worker (LSW) or Licensed Clinical Professional Counselor (LCPC) preferred

See job description