Pride Health · 6 days ago
Case Coordinator
New York, NY, US
Full-time
Onsite
Mid Level
4+ years expPride Health is a company focused on supporting Medicaid members receiving Long Term Services and Supports (LTSS). The Case Coordinator will work collaboratively with Care Managers to ensure members receive timely and high-quality services while performing non-clinical care coordination activities and connecting members to healthcare resources.
Health CareHuman ResourcesInformation Technology
Responsibilities
Conduct monthly outreach calls to assigned members and ensure HIPAA verification
Utilize LTSS monthly assessments and Social Determinants of Health (SDOH) tools during member interactions
Apply critical thinking and sound judgment when addressing unplanned issues and escalate clinical concerns to designated Care Managers
Accurately and timely document all member interactions in the care management system and other applicable software in compliance with professional, regulatory, and organizational standards
Ensure members maintain appointments with healthcare providers
Perform basic care coordination activities, including:
Appointment scheduling
Transportation arrangements
Medication support (prescriptions and refills)
Durable Medical Equipment (DME) coordination
Provide ongoing, non-clinical support to members across diverse ages, cultures, clinical conditions, financial situations, and social environments
Engage members and caregivers in collaborative relationships that empower self-management of physical, psychosocial, and environmental health
Promote effective communication internally and externally to support comprehensive case management services
Maintain accurate and complete documentation in compliance with risk management, regulatory, and accreditation requirements
Protect member confidentiality and adhere to all organizational privacy and HIPAA policies
Collect, compile, and prepare reports, data, and statistics related to LTSS coordination activities
Support efforts that reduce avoidable emergency department visits and hospital admissions, improve member satisfaction and retention, and close gaps in care
Assist internal departments with the resolution of member-related issues, including utilization management, quality management, customer service, and provider relations
Participate in special projects as assigned, including audit preparation, quality improvement initiatives, community health education, and provider or facility relations
Complete all required orientations, annual trainings, and mandatory compliance activities
Ensure compliance with all applicable Federal, State, and City regulations and alignment with the organization’s Mission, Vision, and Values
Qualification
Required
Associate's degree required
Degree must be from an accredited college or university in a healthcare-related field
Minimum of four (4) years of experience in a healthcare-related environment required
Strong proficiency in navigating multiple computer systems and web-based applications
Working knowledge of Microsoft Excel required
Strong integrity, professionalism, and ethical judgment
Customer-focused mindset with demonstrated service excellence
Excellent written and verbal communication skills
Strong organizational and time-management abilities
Ability to prioritize workload and manage shifting demands under pressure
Proven problem-solving skills and ability to work effectively with diverse populations
Collaborative team player with the ability to work independently when required
Preferred
Bachelor's degree preferred
Preferred experience includes Managed Care, Care Management/Coordination, Health Education, Health Home programs, or Community-Based Services
Benefits
Comprehensive healthcare coverage (medical, dental, and vision plans)
Supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity)
401(k)-retirement savings
Life & disability insurance
An employee assistance program
Legal support
Auto, home insurance
Pet insurance
Employee discounts with preferred vendors
Company
Pride Health
Pride Health is a staffing and recruiting company that provides account management and staffing solutions.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Stephanie Barnes
Scheduling Lead PHC/OPWDD
Recent News
2025-11-06
Company data provided by crunchbase