Nurse Care Coordinator

Join the team leading the next evolution of virtual care. At Teladoc Health, you are empowered to bring your true self to work while helping millions of people live their healthiest lives. Here you will be part of a high-performance culture where colleagues embrace challenges, drive transformative solutions, and create opportunities for growth. Together, we’re transforming how better health happens. Summary of Position The Nurse, Care Coordinator provides proactive utilization management services for Teladoc Health members with high-risk needs, inappropriate utilization of urgent or emergent care and/or complex medication needs. This role delivers excellent customer service and facilitates conversations between interdisciplinary care teams, which may include internal and external health care providers, such as Patient Navigators, Care Coordinators, Case Managers, Primary Care Physicians/Specialty Physicians and Hospital Systems.  The Nurse Care Coordinator focuses on providing high quality, cost effective, care coordination. The scheduled shifted will be Monday – Friday 12:30 pm EST – 9:00 pm EST including a Saturday rotation. Essential Duties and Responsibilities Deliver exceptional service to members, providers, care team members and external facilities representing Teladoc Health in a professional and courteous manner through a variety of communication channels including written, telephone, and video. (50%) o Review members’ cases with external health plan risk team and provide advice, direction, and support as needed. Communicate with members after primary care physician appointments to review and update plans of care. Establish and retain patient documentation in external referral/care coordination systems. Process referrals/orders, prescriptions, and prior authorizations in a timely, thorough manner for members, including communication with pharmacy staff and other external medical offices. Manage daily assignment to meet department-specific performance metrics by applying clinical knowledge to support members with care coordination needs (post-visit or posthospitalization) which may include: (50%) o Conduct intake assessment, coordinate treatment plan, and conduct re-assessment of services to ensure coordinated, high-value, in-network care to optimize health outcomes. o Determine members’ eligibility for and refer members to support services (such as health plan case management, external and internal referrals, community resources related to social determinants of health (SDOH) needs). Evaluate and interpret clinical data to identify high-risk members and to implement action-oriented member goals. Analyze complex clinical situations and appropriately provide solutions and resources. o Medication reconciliation. The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs. Supervisory Responsibilities No Qualifications Perfered for Position Compact RN license preferred Certified Case Manager preferred. Prior care coordination experience preferred. Virtual work experience preferred. Ability to work independently and as part of a high performing team. Ability to prioritize/triage patient needs throughout the day, as well as delegate tasks appropriately within the scope of the medical assistant team Ability to receive work instruction and maintain department productivity standards. Exceptional customer service skills. Strong data analysis and clinical assessment skills. Excellent written and verbal communications skills. Strong time management and organizational skills, with ability to effectively manage multiple, competing priorities. Possess a high degree of computer literacy and ability to manage multiple systems, including Microsoft software. Ability to learn new procedures and adapt to changes in fast-paced working environment. Bilingual (English/Spanish) a plus. The above qualifications, knowledge, experience, and/or background are ex ... (truncated, view full listing at source)