Long Term Services and Support Care Specialists/Coordinators provide primary care management to members receiving home and community based waivers. Care management focuses on high risk Medicaid and/or dual-eligible members (adults and children) and utilizes face-to-face visits to conduct assessments and telephonic support for ongoing care coordination needs. This position works intimately with the member and their interdisciplinary care team to enhance quality, improve member outcomes, and encourage appropriate utilization.
Medical Management educates members and empowers them to become active participants in their coordinated health care plans. This team of knowledgeable professionals in their field provide services to include Utilization Review, Medical Outreach, Case Management, Disease Management, Credentialing, Social Work as well as Grievance and Appeals
POSITION DUTIES AND RESPONSIBILITIES
MINIMUM EDUCATION REQUIREMENTS
SPECIAL KNOWLEDGE AND/OR SKILLS
Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs. Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia.
We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.
Our mission is to inspire healthy living within the communities we serve!