A Non-Clinical, supportive and integral role to the Population Health Management (PHM) Case Management Nursing Team working to enhance the quality of member management while assisting in the maximization of both satisfaction and cost effectiveness. The role of Case Coordinator includes data collection, reporting and processes, clinical pulls, case creations in charting platforms and general administrative tasks within the Population Health Management Program. This position is part of a team in the Value Based Care Department.

What Success Looks Like...

In 3 months 

· Ability to work primarily autonomously with completion of basic daily tasks with the oversight from preceptor

· Basic knowledge and ability of navigation of the Utilization and Population Health Management (UM/PHM) Plan, Medical Service Agreement (MSA), Confluence, processes, reporting platforms, Electronic Medical Record systems, and documentation platforms

· Autonomous skills in report pulling and placement, case creations, and appropriate case assignments

In 6 months

· Ability to work autonomously and remotely with little daily oversight from preceptor

· Ability to autonomously perform UM meeting report placement with little corrections

· Ability to perform daily tasks in an organized and efficient manner while adhering to departmental processes

· Effective and professional communication with the team and cross-department collaboration as needed

In 12 months

· Experienced collaboration skills in reporting, case creation and assignments, and departmental communications

· In depth knowledge of the HMO product as it pertains to the PHM program, departmental process, MSA, UM/PHM plan with associated annual expectations of change

· Ability to assist in departmental process creation and process improvement with ability to generate forward thinking attitude and an understanding of productivity, incentives, and departmental goals and outcomes

Role & Responsibilities

• Receiving day to day PHM departmental and member-based reports
• Milliman (MCG) case creations, clinical pulls, and assigning cases to RNs based on group assignment
• Receiving/pulling PHM reports for filing, reporting, and Utilization Management (UM) pre-meeting purposes
• Receiving UM referrals for MCG case creation, clinical pulls, and assigning cases to RNs based on group assignment
• Clinical informative updates in charting platforms including quarterly program updates in the Blue Cross Blue Shield IL (BCBSIL) documentation portal
• Responsible for supporting the PHM nurses to meet the organization's customer requirements and satisfaction
• Assist in departmental process improvement strategies and in creation of internal departmental instructional sheets and processes
• Maintain confidentiality related to all computer programs, medical records and data
• Required attendance at scheduled PHM meetings
• Other responsibilities as assigned based on departmental needs and company requirements

What you'll have

• 1-3 years of experience in a healthcare environment (outpatient office, healthcare facility, health insurance, or other health related environments are acceptable)
• Strong attention to detail with organizational, communication, problem solving, and time management skills
• Ability to ensure timely completion of projects and assignments with the ability to prioritize and react based on rapidly changing business needs
• Must have ability to work independently with multi-tasking skills for fast paced workflows
• Must possess extensive software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc.
• A high speed/secured home internet connection, a home office with a door that locks for security and privacy purposed and back-up connection service options for internet outages

Would love for you to have

• Previous administrative job experience
• Knowledge of medical terminology and/or medical coding
• Experience navigating multiple EMR’s
• Previous remote and/or telephonic work experience

What you get

• Join a high performing team who brings all data into one of the top Healthcare Analytics companies in the US
• Learn a ton about healthcare and edge of healthcare analytics and medical economics
• Become an expert in clinical healthcare data collection and reporting.
• Competitive compensation
• Great benefits like flextime time off
• Autonomous work environment based on trust and mutual respect with the ability of role progression and talent expansion

About Arcadia

Arcadia.io helps innovative healthcare systems and health plans around the country transform healthcare to reduce cost while improving patient health. We do this by aggregating massive amounts of clinical and claims data, applying algorithms to identify opportunities to provide better patient care, and making those opportunities actionable by physicians at the point of care in near-real time. We are passionate about helping our customers drive meaningful outcomes. We are growing fast and have emerged as the market leader in the highly competitive population health management software and value-based care services markets, and we have been recognized by industry analysts KLAS, IDC, Forrester and Chilmark for our leadership. For a better sense of our brand and products, please explore our website, our online resources, and our interactive Data Gallery.

This position is responsible for following all Security policies and procedures in order to protect all PHI under Arcadia's custodianship as well as Arcadia Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.