Managed Care Coordinator I presso CLS Health PLLC

Description

About CLS Health

CLS Health is a growing healthcare system in Houston, Texas that is taking a different approach to healthcare. We are a physician-led healthcare group that focuses on providing patients with holistic, multispecialty care. We're a dynamic team on a mission to provide better healthcare options for Houstonians!

Job Overview: The Managed Care Coordinator plays a vital role in supporting CLS Health’s mission to provide high-quality, patient-centered care. This position is responsible for coordinating care management activities, supporting quality improvement initiatives, and collaborating with providers and health plans to improve patient outcomes, close care gaps, and enhance performance in quality measures and Star ratings. 

Responsibilities:

• Coordinate and monitor patient care activities to ensure timely delivery of services and continuity of care.
• Conduct patient outreach to address care gaps, promote preventive services, and support population health goals.
• Collaborate with providers, clinical teams, and health plans to drive quality improvement and enhance care coordination.
• Review and analyze data related to HEDIS, HCC coding, and other quality performance metrics.
• Document and track patient interactions accurately within the electronic medical record (EMR) system.
• Assist in the implementation of quality initiatives and compliance programs to meet organizational goals.
• Support audits, reporting, and performance reviews as required by internal leadership or external payers.
• Educate patients on care plans and available resources to promote engagement and adherence.

Benefits:

• 401(k)
• 401(k) matching
• Dental Insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Requirements

• High school diploma or equivalent is typically required.
• Prefer 1-2 years customer service or medical support related position.
• Strong background in healthcare (nursing, medical assistant, or care coordination preferred)
• Comprehensive understanding of HEDIS, HCC coding, and quality performance metrics
• Exceptional communication, organizational, and multitasking abilities
• Demonstrated experience in patient outreach, care coordination, and closing care gaps
• Proficiency in electronic medical record (EMR) systems and data reporting tools
• Proven ability to collaborate effectively with providers, clinical teams, and health plans to drive improved outcomes and enhance Star ratings