In collaboration with Care Coordination team members, this position provides support and
guidance to HealthPlan members referred to the Care Coordination Department for Case
Management services and programs. The Health Care Guide I works closely with members,
families, providers, community agencies, and the interdisciplinary care team to assist in
coordination of benefits in a timely and cost-effective manner, while connecting members to
available internal and external resources.

Essential Duties and Responsibilities

▪ Acts as the point of contact for members, families, providers, and/or community agencies
calling into the Care Coordination Department requesting assistance and information
about available Partnership programs and information.
▪ With direction, initiates and processes referrals to appropriate programs in accordance
with department policies, and communicates referral outcomes to referral source.
▪ Collaborates with members, families, providers, and/or community agencies to identify
member needs and/or barriers.
▪ Conducts targeted assessments to identify care coordination needs.
▪ Researches appropriate and available Partnership and/or community resources and provides
guidance to member and interdisciplinary care team.
▪ Creatively utilizes available resources in the most cost-effective manner in collaboration
with the Case Manager.
▪ Assists members to ensure timely access to providers and services.
▪ Initiates and processes referrals to appropriate programs in accordance with department
policies, and communicates referral outcomes to referral source.
▪ Completes timely and accurate documentation in appropriate systems in accordance with
department policies.
▪ Supports the Care Coordination Department by answering the ACD telephone line,
determining call urgency and routing calls appropriately
▪ Provides excellent customer service and communicates with others in accordance with
Partnership standards and expectations.
▪ Exhibits high professional standards as outlined in Partnership’s Code of Conduct
▪ Communicates clearly and effectively through all mediums of communication with
members, providers, vendors, community partners, and Partnership employees.
▪ Responds to inquiries in a timely manner.
▪ Connects members to community agencies when necessary

Secondary Duties and Responsibilities

▪ Obtains records and information as requested by clinical staff.
▪ Provides support and assistance to clinical staff as needed.
▪ Collaborates with internal Partnership departments to resolve issues.
▪ Attends required meetings and trainings in person when assigned.
▪ Provides periodic coverage during vacations or sick time for Health Care Guide staff as
needed within assigned team.
▪ Performs other duties as assigned by the direct supervisor, including the assumption of
new duties.

All HealthPlan employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$29.9535 - $35.1954

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.