Senior Associate - Care Program Coordination

Overview

As a Senior Associate - Care Program Coordination, you will play a pivotal role in guiding members through their healthcare journey by ensuring seamless, coordinated care across clinical programs. Your responsibilities will encompass safeguarding continuity between patients, healthcare providers, and internal teams to facilitate smooth navigation of approved services and drive improved health outcomes. This position requires a blend of clinical insight, operational excellence, and exceptional communication skills to bridge gaps in care delivery and enhance the overall patient experience.

Key Responsibilities

Patient & Case Care Coordination

You will serve as the primary point of contact for members enrolled in clinical programs, providing guidance through approved care pathways, requirements, and next steps. Your role involves coordinating internally to ensure timely processing and follow-up of healthcare service requests—including appointments, referrals, and approvals—from initiation to completion. By proactively liaising with departments such as medical approvals, provider networks, and customer service, you will prevent delays and keep members informed within agreed service levels. Collaboration with healthcare providers, patients, and their families will be essential to facilitate effective care management and drive positive health outcomes.

Patient & Clinical Communication

Your ability to communicate clearly and accurately will be critical. You will provide members with understandable explanations regarding their medical service requests, approvals, and program enrollment status, translating complex medical terminology into patient-friendly language while maintaining clinical precision. For complex clinical inquiries, you will escalate issues to appropriate clinical supervisors or physicians as needed. Additionally, you will facilitate seamless communication between patients and healthcare providers through Dedicated Care Teams to ensure continuity of care.

Clinical Program Support

You will support the execution of clinical programs by tracking patient milestones and adherence to assigned pathways. This includes monitoring enrollment, follow-up schedules, and required documentation, as well as coordinating multidisciplinary interactions when necessary—such as between providers, digital services, and internal teams. Your role will also involve arranging essential resources and services for patients, including referrals to specialists, community services, and support programs, to ensure comprehensive care delivery.

Data Maintenance & Compliance

Accurate documentation is a cornerstone of this role. You will maintain precise and complete records of all member interactions, case notes, and program activities within internal systems while ensuring strict adherence to healthcare data protection regulations. Your contributions to operational reporting—such as caseload status and follow-up completion rates—will support supervisors in monitoring program effectiveness and identifying areas for improvement.

Patient Experience & Service Enhancement

You will address patient concerns related to care navigation within your scope of authority and identify recurring operational issues to escalate to management. Your feedback will be invaluable in refining communication workflows and optimizing patient journey processes to enhance satisfaction and outcomes.

Required Skills & Qualifications

• Clinical Knowledge: A strong understanding of medical terminology and basic clinical pathways.
• Healthcare Processes: Familiarity with healthcare authorization and service request processes.
• Technical Proficiency: Experience with healthcare information systems and documentation tools.
• Communication: Exceptional verbal and written communication skills to engage with diverse stakeholders.
• Organizational Abilities: Capacity to manage multiple cases simultaneously with meticulous attention to detail.

Education & Experience

A degree in Nursing, Health Sciences, Public Health, or a related healthcare field is required to qualify for this role. Prior experience in care coordination, case management, or a clinical support capacity within the healthcare industry is highly desirable.