Case Coordinator

Company: PRIDE Health
Location: New York City
Posted on: January 22, 2026

Job Description:

Job Description The LTSS Coordinator supports Medicaid members receiving Long Term Services and Supports (LTSS) by working collaboratively with Care Managers and leadership to ensure members receive appropriate, timely, and high-quality services. Under the direction of the LTSS Manager and Care Manager, this role conducts monthly outreach, performs non-clinical care coordination activities, and connects members to healthcare and community resources to improve outcomes, reduce avoidable utilization, and enhance member satisfaction. Scope of Role & Responsibilities Conduct monthly outreach calls to assigned members and ensure HIPAA verification Utilize LTSS monthly assessments and Social Determinants of Health (SDOH) tools during member interactions Apply critical thinking and sound judgment when addressing unplanned issues and escalate clinical concerns to designated Care Managers Accurately and timely document all member interactions in the care management system and other applicable software in compliance with professional, regulatory, and organizational standards Ensure members maintain appointments with healthcare providers Perform basic care coordination activities, including: Appointment scheduling Transportation arrangements Medication support (prescriptions and refills) Durable Medical Equipment (DME) coordination Provide ongoing, non-clinical support to members across diverse ages, cultures, clinical conditions, financial situations, and social environments Engage members and caregivers in collaborative relationships that empower self-management of physical, psychosocial, and environmental health Promote effective communication internally and externally to support comprehensive case management services Maintain accurate and complete documentation in compliance with risk management, regulatory, and accreditation requirements Protect member confidentiality and adhere to all organizational privacy and HIPAA policies Collect, compile, and prepare reports, data, and statistics related to LTSS coordination activities Support efforts that reduce avoidable emergency department visits and hospital admissions, improve member satisfaction and retention, and close gaps in care Assist internal departments with the resolution of member-related issues, including utilization management, quality management, customer service, and provider relations Participate in special projects as assigned, including audit preparation, quality improvement initiatives, community health education, and provider or facility relations Complete all required orientations, annual trainings, and mandatory compliance activities Ensure compliance with all applicable Federal, State, and City regulations and alignment with the organization’s Mission, Vision, and Values Required Education, Training & Experience Associate’s degree required; Bachelor’s degree preferred Degree must be from an accredited college or university in a healthcare-related field Minimum of four (4) years of experience in a healthcare-related environment required Preferred experience includes Managed Care, Care Management/Coordination, Health Education, Health Home programs, or Community-Based Services Strong proficiency in navigating multiple computer systems and web-based applications Working knowledge of Microsoft Excel required Licensure / Certification None required Professional Competencies Strong integrity, professionalism, and ethical judgment Customer-focused mindset with demonstrated service excellence Excellent written and verbal communication skills Strong organizational and time-management abilities Ability to prioritize workload and manage shifting demands under pressure Proven problem-solving skills and ability to work effectively with diverse populations Collaborative team player with the ability to work independently when required Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Keywords: PRIDE Health, New Britain , Case Coordinator, Healthcare , New York City, Connecticut