Care Coordinator (EPSDT) - Hybrid in Hampton Roads, VA

City/State

Norfolk, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health is seeking to hire a qualified individual to join our team as a Care Coordinator (EPSDT.

Position Status: Full-time, Day Shift

Position Location: Will work remotely some days and meet members at their home or out in the community

Standard Working Hours: 8:00AM to 5:00PM

Minimum Requirements:

• Associate's degree in Nursing preferred.

• Bachelor's degree in Health & Human Services-related field or related experience in lieu of education accepted.

• Licensed Practical Nurse (LPN) or Bachelor's prepared health professional strongly preferred

• MCO/HMO experience, 3 years of clinical experience within the last 5 years.

• 3 years of Medicaid/Medicare experience preferred.

• Familiar with HEDIS measures, EPSDT, and childhood immunizations charts and periodicity schedule. Utilization Management experience and Chart review/audit experience preferred.

Job Description Summary

Responsible for facilitation, implementation and coordination of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Member Outreach Program and overall compliance with immunization and EPSDT examinations. Serves as health plan resource for EPSDT/Well Child Program and all childhood exams, screenings, and vaccinations recommended by DMAS and per HEDIS measures. Responsible for data entry and monitoring of reports to increase utilization of EPSDT services. Maintains tracking system to identify new enrollees and children's non-compliance with EPSDT periodicity and immunization schedules. 

Ensures access to periodic preventive health care for members under the age of 21 years by promoting and coordinating child wellness in alignment with DMAS, health plan, and other professional organization initiatives. Conducts notifications of periodic screening requirements; develops educational materials and provides training to members/providers. Triages members with special healthcare needs (CSHN) using appropriate screening tools and assessments. Provides complex case management to members with complex needs. Performs related field work and community engagement travel as needed to increase EPSDT awareness and compliance. May assist with EPSDT policies/procedures and completing service authorizations.

Diversity and Inclusion at Sentara

Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.

We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community. We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.

Our strategies focus on both structural inclusion, which looks at our organizational structures, processes, and practices; as well as behavioral inclusion, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.

Please visit the link below to learn more about Sentara’s commitment to diversity and inclusion:

https://www.sentara.com/aboutus/mission-vision-and-values/diversity.aspx

Sentara Overview
For more than a decade, Modern Healthcare magazine has ranked Sentara Healthcare as one of the nation's top integrated healthcare systems.  That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.

Sentara Benefits
As the third-largest employer in Virginia, Sentara Healthcare was named by Forbes Magazine as one of America's best large employers.  We offer a variety of amenities to our employees, including, but not limited to: