Job Title : Care Coordinator

Reports To : Program Manager, Clinical Navigation

Job Summary : Collaborates with clinical team members, patients, and families to facilitate unmet health care needs within the context of the Patient Centered Medical Home (PCMH) model.

Qualifications and Requirements :

The requirements listed below are representative of the knowledge, skill, and / or ability required. Job duties may be modified at any time based on business needs.

Essential Job Duties :

Promotes the PCMH Model

• Assists in promoting and implementing PCMH initiatives.
• Regularly participates in leadership, staff, and other quality improvement meetings to educate staff and facilitate participation in PCMH initiatives.
• Represents CCHCI's implementation of PCMH within the context of institutional and community forums.
• Performs duties related to Quality Department projects as assigned.
• Promotes and Provides Care Coordination
• Coordinates preventative health care measures and health care maintenance for defined patient populations.
• Manages insurance company correspondence regarding patient care.
• Identifies and tracks patients in need of follow up and other testing for chronic disease management in collaboration with provider.
• Follows up on missed appointments for defined patient populations.
• If within scope, provides patient education for disease management and assists providers with lab and diagnostic study follow up.
• Organizes and facilitates care planning for defined patients.
• Arranges in-home medical care such as home health, hospice, and in-home durable medical equipment and oxygen needs.
• Facilitates hospital admissions.
• Tracks and coordinates follow up of hospitalized patients upon discharge and obtains in-patient medical records.
• Coordinates Specialty Care
• Builds and maintains relationships with specialists and other medical services.
• Negotiates rates for underinsured and uninsured populations.
• Follows up on outstanding referrals.
• Assists patients with potential barriers to specialty care.
• Coordinate in-house clinics for visiting specialists in collaboration with leadership team.
• Manages and submits necessary documentation to insurance for coverage of transportation.
• Negotiates rates with local transportation companies for uninsured populations.

Required Minimum Qualifications - Expérience, Certificates & Licences :

• High School Diploma or GED
• Two years of experience in case management, social work, or other related health care field.
• Any combination of education and / or experience that provides the necessary skills required may be considered.
• Valid Fingerprint Clearance Card required.

Preferred Qualifications - Experience, Certificates & Licenses :

Associate degree in a field of case management, social work, or related field preferred.

Required Language Skills :

• Ability to comprehend and compose instructions, correspondence and communications in English and Spanish in both oral and written format.
• Bilingual in English and Spanish with knowledge of medical terminology is required.

Physical Requirements :

• Ability to frequently exert enough force to move objects weighing up to 25 pounds.
• Ability to continuously remain in a stationary position.
• Ability to frequently move about inside the workplace to assist patients, operate office or medical equipment, etc.
• Possesses hand-eye coordination and manual dexterity necessary to constantly operate computers, telephone, and other office machinery.
• Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
• Ability to discern the nature of sounds at a normal spoken volume.

Other Required Knowledge, Skills, and Abilities :

• Ability to add, subtract, multiply, and divide in all measure, using whole numbers, common fractions, and decimals.
• Ability to gather data in an organized fashion from varied sources.
• Ability to perform a variety of assignments with little or no direct supervision.
• Knowledge of health plans and community health centers preferred.
• Knowledge of HIPAA rules and regulations.
• Computer literacy is required with proficiency in the use of all Microsoft Office programs.
• Ability to provide excellent customer service by mail, telephone, and in-person.

Work Environment & Conditions :

• Work environment is typical of a health clinic setting with occasional exposure to communicable diseases, bodily fluids, and hazardous chemicals.
• Occasionally, work requires extended hours to include early mornings, evenings, and weekends.

Last updated : 2024-06-16