Medical Services Coordinator

Summary

Description

General responsibilities include but are not limited to the following:
• Responsible for managing, scheduling, and tracking all individuals supported medical, dental, psychiatric, vision, hearing, neurological, and specialty appointments while maintaining accurate documentation in compliance with DDA, MCO, and licensure requirements.
• Coordinate and provide transportation and accompaniment for individuals supported to and from medical appointments, programs, and employment as needed.
• Oversee medications for individuals supported, including ordering, reordering, deliveries, pickups, and communication with Sunshine Services’ pharmacy.
• Conduct weekly medication audits in each residential home to ensure medication accuracy, proper storage, documentation compliance, and adherence to agency policies and regulatory requirements. Report all discrepancies and concerns to the Residential Director immediately and follow up to ensure corrective actions are completed.
• Provide education to individuals supported regarding medical procedures, treatments, medications, and healthcare needs as appropriate.
• Obtain and maintain all required annual medical consents and healthcare authorizations for individuals supported.
• Participate in monthly team meetings and meet weekly or bi-weekly with the Residential Director to review medical needs, compliance, and ongoing priorities.
• Attend annual Person-Centered Support Plan (PCSP) meetings or provide updated medical information for presentation by a Sunshine Services representative.
• Submit medical encounter documentation from annual and specialty appointments to Independent Support Coordinators, DDA Case Management, and other required parties via email or fax.
• Collaborate with Case Managers regarding medical information that impacts PCSPs, assessments, reports, and other required documentation.
• Coordinate and manage medication check-ins, organization, distribution, and delivery of all cycle medications for individuals supported.
• Ensure daily notes for all medical appointments are completed within the agency’s 48-hour documentation requirement.
• Ensure interpreter services are scheduled and available for individuals supported requiring language assistance during medical appointments.
• Collaborate with the Representative Payee/Client Finance Department regarding Explanation of Benefits (EOBs), MCO cancellations, TennCare appeals, medication co-pays, medical billing concerns, and other financial matters related to the healthcare of individuals supported.
• Plan and coordinate discharge meetings and ensure continuity of care for individuals supported following discharge.
• Initiate, maintain, and manage patient portals for individuals supported to facilitate communication with healthcare providers and access to medical records.
• Perform other duties as assigned that support the health, safety, and well-being of the individuals supported and the operational effectiveness of Sunshine Services.

The Medical Services Coordinator is directly responsible to the Residential Director. The Medical Coordinator will be expected to fulfill any reasonable request for service that is within the stated purpose of Sunshine Services. He/She will be bound by the regulations stated in the Sunshine Services Policy Manual, any subsequent regulations that become part of Sunshine Services policy, and the Staff Handbook.

Requirements

Education Requirements: A high school diploma or equivalent is required. A minimum of one year of experience in healthcare coordination, medical scheduling, social services, or a related field is preferred. Experience working with individuals with intellectual and developmental disabilities, medical providers, or healthcare systems is strongly preferred.

Position Requirements: Complete all required DDA and MCO trainings in a timely manner. Maintain all required certifications and complete annual refresher trainings as required. Successfully complete and maintain certification for Medication Administration. Demonstrate proficiency in Microsoft Office applications, including Word, Outlook, and Excel, as well as electronic health record and documentation systems. Possess strong written and verbal communication, organizational, and documentation skills. Must be at least 21 years of age, possess a valid Tennessee driver’s license, and be insurable by the agency’s insurance carrier.