Job Description:

The Care Coordinator is responsible for administering the care coordination plan provided by the patient’s primary care practice. 

ESSENTIAL FUNCTIONS:

• Provide guidance and support to patient both before and after medical appointments

• Engage and educate the patient in setting goals that target improvement in overall health

• Works with IT resources to facilitate registry reporting at the site & documentation of EBC in searchable fields – I do not understand this duty,

• Complies HIPAA regulations

• Performs other related work as required

• Partners with care teams to support an assigned panel of chronic care patients (low acuity): >250

• Provide follow-up contact with patient as indicated to ensure compliance with recommendations – medications, lab/x-ray, specialist visits, PCP visits, dieticians, CDE, etc.

• Oversees referrals to specialists, ancillary testing, and other enabling services;

• Coordinates access to telephonic medical advice

• Collaborates with the patient, physician, and other care team members in assessing the patient’s progress toward individual health care goals;

• Partner with patient and family members to identify and mitigate barriers to treatment

• Provide information and resources to patients in support of their wellness goals Serve as a patient advocate and negotiate with health plan care managers on behalf of the patientServe as the primary point of contact during care transitions between consulting physicians and  hospitals, Emergency Rooms, skilled nursing facilities,Provide information and guidance to patients and/or family regarding effective care transitions and enhanced patient-care team communication

• Maintain accurate and timely documentation within the Care Coordinator I’s scope of practice.

• Represents care coordination program on performance improvement teams.

• Perform general clerical duties, these include but are not limited to making outbound calls to patients, documenting calls in EMR., photocopies, scanning, typing, answering messages in EMR in a timely manner.

• Maintains work area organized

EDUCATION AND EXPERIENCE

• Active Medical Assistant certification

• Current Basic Life Support certificate

• Minimum of one (1) year medical experience in physician’s office

• Advance knowledge of medical terminology

• Experience in Primary Care with this population is highly desirable

• Supports practice mission and goals

• Bilingual Spanish may be preferred

KNOWLEDGE, SKILLS, ABILITIES:

• Ability to demonstrate collaboration, communication, service, transparency, and teamwork.

• Results-oriented and persistent in achieving success

• Ability to demonstrate commitment to quality, performance and service excellence. It will be critical that they have experience and a high degree of comfort working within a highly matrixed environment.

• A team player who promotes partnerships and builds trust and strong relationships.

Salary Range:

$19.71-26.28 hourly