This is a work-from-home position with travel required within Greenville, SC county, including these cities:

Pelham, SC; Mauldin, SC; Simpsonville, SC; and Greenville, SC  
Mileage is reimbursed for travel.

Position Summary:

The On-site Care Coordinator is a Registered Nurse who provides care coordination, education and outreach services on-site (various locations including home) to Medicaid members in the Medically Complex Children’s Waiver program. This position requires licensure as a Registered Nurse in the State of SC.

Essential Duties and Responsibilities:

• Schedules appointments and visits the home to complete a comprehensive assessment determining Nursing Facility or Institutional level of care requirements.
• Receives and reviews the LOC (level of care) forms and medical records supplied by DHHS that qualifies participation in the MCCW program.
• Provides parents/guardians with education required to care for child or arranges appropriate education services.
• Develops case specific care plans and presents to provider for approval and/or revision; submits care plan to DHHS for approval.
• Coordinates with Care Advocate to assist in securing the services approved on the care plan.
• Maintains availability to family/guardian and providers to coordinate any required services.
• Develops disaster plan, identifies availability of advanced directives, needs for ancillary services, specialty services and community services.
• Identifies any complaints and/or grievances.

 Supervisory Responsibilities: None

Qualifications: 

Education and/or Experience:

• A Minimum of three (3) years of recent clinical pediatric experience is required.
• A Bachelor’s degree in a health-related field is strongly preferred.
• Previous work experience with a Medicaid program is preferred.
• Bilingual (Spanish) is preferred.
• Ability to travel locally with a valid drivers’ license and automobile insurance.
• Criminal background check as required by the state where business is conducted
• Initial TB negative test

Competencies:

• Strong organizational, interpersonal and motivational skills
• Excellent written and verbal communication skills
• Detail oriented
• High level of reasoning and analytical skills
• Ability to multi-task and work independently

Certificates, Licenses, Registrations: 

• Certified Case Management (CCM) Certification is required within four (4) years of employment. Other certifications recognized by URAC are also acceptable.
• Current RN licensure in states where business is conducted.
• Current BLS certification

Computer Skills:

Proficiency using software programs such as MS Word, ACCESS, PowerPoint, Excel and Outlook

Environmental Factors/Physical Demands: 

Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.

HIPAA and Data Privacy Obligations:

This role has direct access to Protected Health Information (PHI). The following rules are non-negotiable:

• Absolute confidentiality: Employees must not disclose PHI to unauthorized individuals under any circumstances.
• Secure environment: A private, locked workspace must be maintained to prevent exposure of PHI to family members, visitors, or others.
• Company-approved technology only: All work must be performed on secure, company-issued devices using encrypted connections (VPN required).

Other Responsibilities:

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee.  Duties, responsibilities, and activities may change at any time with or without notice. 

• • • Adheres to the policies and procedures of Company
    • Maintains strict confidentiality of client, company and personnel information
    • Demonstrates a strong commitment to the mission and values of the organization
    • Adheres to company attendance standards
    • Performs other duties as assigned 

At-Will Employment (South Carolina):

Employment with Community Health Solutions of America (“CHS”) is at-will and does not constitute any promise of permanent or perpetual employment, nor does it constitute a promise of future income. Either you or the Company may terminate your employment arrangement and/or associated terms at any time, with or without cause.

Drug Free Workplace Program:

Premier Family of Companies and its affiliates is committed to providing a safe, healthy, and productive work environment for all employees. To achieve this Premier Administrative Solutions (“CHS”) maintains a smoke-free and drug-free workplace.  Candidates who receive a conditional offer must complete a pre-employment drug screen.  Random and post-incident testing may also be required.

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