The role of the Member Care Coordinator (MCC) is to serve as the liaison between the member and the healthcare system. The MCC will coordinate and monitor care ensuring: 1) members medically necessary needs are being met and 2) regulatory administrative requirements are met.
MCC’s will coordinate care for up to 200 members identified as low needs. The MCC works in collaboration and continuous partnership with staff and other professionals providing direct services to members. The MCC will work with the Recovery Coach (RC) as a team to ensure the following goals are met:
• 100% of members receive a treatment service (all services outside of case management) within a 90 day period.
• 100% of assessments and service plans are up to date and in accordance with standards.
• All services billed are 85% of the PMPM rate.
• 100% of families are contacted to discuss no show and lack of participation in services
• No show rates do not exceed 10% for all scheduled services
• Reviews assessment and service plan within 48 hours of case assignment.
• Contacts member/guardian within 48 hours of case assignment to set up initial meeting (case management service).
• Conducts initial meeting with family within 7 days of case assignment (family support service).
• Using the Electronic Health Record ensures member has been enrolled in services referred within 2 weeks of case assignment.
• Using the Electronic Health Record ensures member is participating in services. This must be conducted monthly.
• Using the Electronic Health Record reviews Psychiatric notes on a monthly basis.
• Using the Electronic Health Record monitors treatment services (all services outside of case management) monthly ensuring members have a treatment services at least every 90 days.
• Works with the Recovery Coach to conduct face to face visits for all members not having a treatment service within 75 days
• Contacts member via phone for all no shows and lack of participation in scheduled sessions (case management service). Must make contact with family within 15 days otherwise a home visit must be made.
• Conducts CFT as needed or at a minimum every 90 days (case management service).
• Updates Assessment, Service Plan, CASII and demographic as needed or within 365 days of the last assessment.
• Using the electronic Health Record reviews all PCP information.
• Contacts collateral contacts via phone.