Clinical Care Coordinator

Job Description

Job Title: Clinical Care Coordinator (Doctor Role)

Location: Indira Nagar, Bengaluru

Reports To: Operations Head- Managed Care

Department: Managed Care Operations

Job Summary

We are seeking experienced Clinical Care Coordinators (BHMS, BAMS) to join our Managed Care team. This is a crucial role within our Managed Care initiative, where the health and wellness of our members are our top priority.

As a Clinical Care Coordinator, you will be the primary clinical touchpoint for our members. You will assess members health needs, provide personalized care recommendations, answer member queries on health and the membership plan and coordinate services such as doctor consultations, diet consultations, and preventive health checks to ensure that members receive the care and support they need for optimal health and wellness. This non-clinical role requires you to utilize your clinical knowledge to help manage the health and wellness of our members while working closely with the internal medical team and operational staff. You will report directly to the Operations Head - Managed Care, contributing to the overall success of our strategic Managed Care initiative.

Key Responsibilities

- Health and Wellness Assessments:

Conduct thorough health assessments of members, identifying their individual health needs, conditions, and wellness goals.

Leverage your clinical expertise to evaluate members health status and make informed

recommendations for necessary services, including doctor consultations, diet consults, and preventive health checks.

Review members health histories and current concerns to provide personalized care advice that aligns with their overall wellness plan.

- Coordinating Member Services: Book and coordinate necessary services for members, including doctor consultations (specialist and general), diet consultations, preventive health screenings, and wellness programs. Collaborate with the internal medical team, including physicians, specialists, and dietitians, to ensure that members receive the appropriate care and treatment based on their health assessments. Ensure all services are scheduled promptly and efficiently to meet the needs of members.
- Care Plan Management: Develop and manage individual care plans for members, outlining the required medical services, preventive health checks, and other wellness initiatives. Monitor the execution of care plans, ensuring that members adhere to their health and wellness schedules, and track progress over time. Follow up with members to ensure satisfaction with services, address any concerns, and ensure they are on track to meet their health and wellness goals.
- Clinical Liaison: Serve as the clinical touchpoint for members, answering their questions about health services, treatment options, and wellness initiatives. Collaborate with the Operations Head of Managed Care to ensure that clinical operations are in line with company objectives and members needs. Facilitate communication between members and internal healthcare providers to ensure that all aspects of care are coordinated and delivered smoothly.
- Health Education and Support: Provide educational resources to members about health maintenance, preventive care, and lifestyle modifications. Empower members to take control of their health by offering advice on nutrition, exercise, and other wellness strategies. Support members in achieving their health and wellness goals through regular guidance and follow-up.
- Clinical Documentation and Reporting: Maintain accurate and up-to-date records of health assessments, care plans, and services provided to each member. Document all interactions with members, tracking progress, changes in health status, and any new recommendations or care adjustments. Provide regular reports to the Operations Head of Managed Care regarding member health trends, service utilization, and care plan outcomes.
- Quality Assurance and Compliance: Ensure all care activities meet the highest clinical standards and comply with healthcare regulations, company policies, and best practices. Monitor the quality of services provided to members, working to continually improve care delivery and patient satisfaction. Participate in ongoing quality improvement efforts within the Managed Care team.

Required Qualifications

- Education: A degree in a clinical field such as BHMS (Bachelor of Homeopathic Medicine and

Surgery), BAMS (Bachelor of Ayurvedic Medicine and Surgery).

- Experience: Prior clinical experience, particularly in a healthcare coordination or

patient care role, is required. A hospital experience will be a plus.

- Skills:

Strong clinical knowledge

Excellent communication and interpersonal skills to effectively engage with

members, healthcare providers, and internal teams.

Strong organizational skills to manage multiple member care plans and

services simultaneously.

Proficiency with healthcare management software, electronic medical records

(EMR), and basic office tools.

Ability to assess member health needs and recommend appropriate services

for optimal care.

Preferred Qualifications

- Experience in a patient coordination or care management role within a healthcare

setting.

- Familiarity with managed care operations, preventive health services, and wellness

programs.

- Knowledge of healthcare insurance processes and medical billing.
- Understanding of regulatory requirements and clinical standards in managed care.

Work Environment

This role is based in a healthcare environment, and the Clinical Care Coordinator will

interact directly with members and healthcare providers to ensure high-quality, coordinated

care. You will work closely with the Operations Head of Managed Care to ensure that the

strategic objectives of the managed care initiative are being met, with a strong focus on the

health and wellness of the members.

Why Join Us

This is a unique opportunity for clinicians with a background in BHMS & BAMS, to play a pivotal role in the Managed Care initiative. You will be at the forefront of member care, helping individuals manage their health and wellness through personalized care plans, consultations, and preventive health services. If you're passionate about improving patient outcomes, enhancing healthcare delivery, and supporting a holistic approach to wellness, we encourage you to apply

Skills: clinical care,healthcare,interpersonal skills,strong clinical knowledge,proficiency with healthcare management software,strong organizational skills,managed care,care plans,electronic medical records (emr),ability to assess member health needs,basic office tools,wellness,health,excellent communication skills