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Clinical Care Coordinator
Job Description
Position Summary
The Clinical Care Coordinator is a licensed Registered Nurse (RN) OR Licensed Clinical Social Worker (LCSW) responsible for the delivery and oversight of care coordination functions across behavioral and physical health domains. This role is a critical by supporting and delivering exceptional quality-driven, member-focused services.
Key Responsibilities
Care Coordination Support
•   Deliver coordinated services to all members, including those with complex medical, behavioral health, and developmental needs.
•   Collaborate with the TPA regarding care coordination workflows, transitions of care, and high-risk member support.
•   Monitor key health indicators and recommend interventions to reduce avoidable emergency visits, hospitalizations, and readmissions.
Reporting Support
•   Preparation and submission of Clinical Data Requirements List (CDRL)Â
•   Coordinate with analysts and the TPA to verify data accuracy and completeness.
•   Support reporting analysis to inform clinical care strategies and program improvements.
•   Contribute to audit preparation and support compliance with documentation standards.
Clinical Quality & Performance Improvement
•   Monitor clinical quality measures such as HEDIS and other TRICARE standards.
•   Collaborate with internal teams to support and implement care interventions aligned with quality goals.
•   Evaluate care plans, adjust as needed, and track member progress toward improved outcomes.
•   Recommend process improvements to enhance clinical operations and care efficiency.
Member & Provider Interaction
•   Guide members through the healthcare system with a focus on advocacy, cost-effective resource utilization, and person-centered care.
•   Educate members and providers on TRICARE benefits, community-based resources, and support programs.
•   Facilitate effective transitions of care and ensure timely, coordinated service delivery across providers and systems of care.
Administrative Support
•   Support operational planning and team goals.
•   Contribute to development of policies and procedures in alignment with contract expectations.
•   Perform additional tasks to support the department and ensure timely service delivery
Qualifications
Education & Experience
•   Minimum 3-5 years of care coordination or case management experience.
•   Familiarity with TRICARE, ECHO, ACD, and DHA/DoD health system standards preferred.
Licensure & Certifications
•   Active RN license or LCSW in the state of Massachusetts, Connecticut, New Hampshire or Rhode Island.
Skills & Competencies
•   Strong documentation, organizational, collaboration and communication skills.
•   Critical thinking and problem-solving skills.
•   Proficiency in EMR systems, reporting tools, and regulatory documentation.
#ZRDH
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The Clinical Care Coordinator is a licensed Registered Nurse (RN) OR Licensed Clinical Social Worker (LCSW) responsible for the delivery and oversight of care coordination functions across behavioral and physical health domains. This role is a critical by supporting and delivering exceptional quality-driven, member-focused services.
Key Responsibilities
Care Coordination Support
•   Deliver coordinated services to all members, including those with complex medical, behavioral health, and developmental needs.
•   Collaborate with the TPA regarding care coordination workflows, transitions of care, and high-risk member support.
•   Monitor key health indicators and recommend interventions to reduce avoidable emergency visits, hospitalizations, and readmissions.
Reporting Support
•   Preparation and submission of Clinical Data Requirements List (CDRL)Â
•   Coordinate with analysts and the TPA to verify data accuracy and completeness.
•   Support reporting analysis to inform clinical care strategies and program improvements.
•   Contribute to audit preparation and support compliance with documentation standards.
Clinical Quality & Performance Improvement
•   Monitor clinical quality measures such as HEDIS and other TRICARE standards.
•   Collaborate with internal teams to support and implement care interventions aligned with quality goals.
•   Evaluate care plans, adjust as needed, and track member progress toward improved outcomes.
•   Recommend process improvements to enhance clinical operations and care efficiency.
Member & Provider Interaction
•   Guide members through the healthcare system with a focus on advocacy, cost-effective resource utilization, and person-centered care.
•   Educate members and providers on TRICARE benefits, community-based resources, and support programs.
•   Facilitate effective transitions of care and ensure timely, coordinated service delivery across providers and systems of care.
Administrative Support
•   Support operational planning and team goals.
•   Contribute to development of policies and procedures in alignment with contract expectations.
•   Perform additional tasks to support the department and ensure timely service delivery
Qualifications
Education & Experience
•   Minimum 3-5 years of care coordination or case management experience.
•   Familiarity with TRICARE, ECHO, ACD, and DHA/DoD health system standards preferred.
Licensure & Certifications
•   Active RN license or LCSW in the state of Massachusetts, Connecticut, New Hampshire or Rhode Island.
Skills & Competencies
•   Strong documentation, organizational, collaboration and communication skills.
•   Critical thinking and problem-solving skills.
•   Proficiency in EMR systems, reporting tools, and regulatory documentation.
#ZRDH
Â
Meet Your Recruiter
Ashley Dineen
Ashley Dineen has been with The Panther Group since 2009 and has worked within many areas of the company including payroll, compliance, on-boarding, recruitment, and client management.
Ashley is a mother of two and enjoys spending time with family in her spare time.
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