Company: Magellan Health
Location: Baton Rouge
Posted on: September 15, 2021
The position will serve as the Wraparound Coordinator to
facilitate department workflow by supporting clinical team with
various care coordination workflows. Locates community services and
other referral locations for enrollees, arranges access to care,
supports communication with hospitals, and providers.
This position locates services for patients and members with the
goal of supporting the coordination of care such that members are
able to access care in a timely manner and to remain in the least
restrictive level of care appropriate to their functioning.
Facilitates continuity of care as patients move through levels of
care as authorized by clinical staff. Responsible for
problem-solving and explaining company programs and procedures to
clients and providers. May be assigned additional special
responsibilities commensurate with experience and qualifications,
such as TRF (Treatment Request Form) review, CISD (Critical
Incident Stress Debriefing) assistance, clinical decision follow up
support or other clinical support as needed. Will coach and precept
new hires and less experienced staff in all elements of the role
responsibilities as detailed below.
- Troubleshoots for the clinical team when an appropriate
provider, type of service, or appropriate level of care cannot be
- Links clients to appropriate services within the
- Assists in discharge planning for hospitalized patients and
makes appropriate placements as needed.
- Participates in the treatment team and assists in coordinating
physical, psychological and/or psychiatric services for the
- Provides information to members and providers regarding mental
health, physical health and/or substance abuse benefits, community
treatment resources, mental health managed care programs, and
company policies and procedures.
- Assists in the adhoc process either in submitting adhocs as the
designated adhoc Care Worker or assisting Care Managers in
completing the form correctly and, in utilizing search features for
securing credentialed providers for appointments as
- Assists in monitoring the CW/Gatekeeping queue during the
- Participates in quality activities, including data collection,
tracking, and analysis.
- Assists efforts to continuously improve by assuming
responsibility for identifying and bringing to the attention of
responsible entities operations problems and/or inefficiencies with
possible suggestions for more effective processes.
- Leads or participates in activities as requested that improve
Care Center/Health Plan performance, excellence and
- Supports team members and participates in team activities that
build a high-performance team.
- Demonstrates flexibility in areas such as job duties and
schedule in order to aid in better serving members and help the
company achieve its business and operational goals.
- Demonstrates proficiency, ability and willingness to perform
all responsibilities including but not limited to, Ambulatory
Follow Up, Account Specific Follow Up, Community Resource Requests
and basic file room procedures.
- Assumes responsibility for self-development and career
progression. Proactively seeks and participates in ongoing training
(formal and informal) in all aspects of the role.
- Remains responsible for updating self on ever changing
information to ensure accuracy when dealing with members and
providers and procedures.
- Contributes to process improvements to enhance achievement of
personal, team and company goals.
- Experience in a managed care environment and/or
integrated medical and behavioral health care.
Understanding of plan benefit structures,
psychiatric/medical terminology, and local communication
Certifications - Required
Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity
Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the
security responsibilities and security controls unique to their
position; and comply with all applicable legal, regulatory, and
contractual requirements and internal policies and procedures.
Keywords: Magellan Health, Baton Rouge , Wraparound Coordinator, Other , Baton Rouge, Louisiana
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