Job Summary: The MDPCP Care Coordinator is responsible for coordinating and managing the care of patients Medicare recipients enrolled in the Maryland Primary Care Program. Working closely with healthcare providers, patients, and other members of the healthcare team, the Care Coordinator ensures that patients receive high-quality, coordinated care that meets their healthcare needs and improves health outcomes.

Key Responsibilities:

Patient Care Coordination: Coordinate and manage the care of patients enrolled in the MDPCP, including identifying patients in need of care management services, assessing their needs, and developing care plans in collaboration with healthcare providers.

Care Plan Development: Develop comprehensive care plans for patients, incorporating input from healthcare providers, patients, and other members of the care team. Ensure that care plans address the patient's medical, social, and behavioral health needs.

Patient Education and Support: Provide education and support to patients and their families, helping them understand their conditions, treatment options, and self-management strategies. Assist patients in navigating the healthcare system and accessing community resources.

Communication and Collaboration: Facilitate communication and collaboration among healthcare providers, specialists, and other members of the care team to ensure seamless coordination of care. Serve as a liaison between patients and providers, advocating for the patient's needs and preferences.

Monitoring and Follow-Up: Monitor patients' progress towards their health goals, regularly reviewing care plans and adjusting them as needed. Conduct regular follow-up with patients to assess their status, address any barriers to care, and provide ongoing support.

Data Management and Reporting: Maintain accurate and up-to-date records of patient interactions, care plans, and outcomes in accordance with program requirements. Collect and analyze data to track program performance and identify areas for improvement.

Quality Improvement: Participate in quality improvement initiatives aimed at enhancing the delivery of care within the MDPCP. Collaborate with healthcare providers and other stakeholders to implement best practices and achieve program goals.

Qualifications/Requirements:

Bachelor's degree in nursing, social work, or a related field.

Licensure or certification as a registered nurse (RN), licensed social worker (LSW), or similar healthcare professional.

Must have previous experience in medical case management, care coordination, or a related field, preferably in a primary care or community health setting, basic computer skill knowledge.

Strong interpersonal and communication skills, with the ability to build rapport with patients and collaborate effectively with multidisciplinary teams.

Knowledge of chronic disease management, care transitions, and healthcare quality improvement principles. Familiarity with electronic health record (EHR) systems and health information technology tools.

Commitment to patient-centered care, cultural competence, and health equity.

Job Types: Full-time, Part-time

Pay: From $30.00 per hour

Expected hours: No less than 32 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Medical specialties:

• Primary Care

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Outpatient

Work Location: In person