Patient Care Coordinator LPN/RN

The Care Coordinator supports clinics initiatives toward clinical integration and accountable care strategies to achieve the triple aim in healthcare: 1) improving quality and patient satisfaction, 2) improving outcomes and the overall health of the population, and 3) reducing the total cost of care. Through risk stratification tools available to Population Health, the Population Health Care Coordinator identifies patients with a need for early intervention related to discharge education, transitional care or disease management and coordinates intervention with PCPs and other care providers. The MVH Care Coordinator also refers to medical and behavioral health providers as appropriate for further intervention.

DUTIES AND RESPONSIBILITIES:

MA/LPN Care Coordinator

• Work under direct supervision of RN supervisor to provide excellent patient care to all clients.
• Participate in the transition of all outside clinics into the ACO/PCMH.
• Engages with population health team on Quality Based programs in the clinics.
• Offers solutions to road blocks while implementing programs.
• Run needed reporting to track MIPS and ACO measures
• Run CCM and Annual Wellness Visit outreach reporting for all clinics to work through and help with outreach.
• Monitor high risk patients within each clinic and follow up appropriately with clinic staff or RN care coordinator within Population Health.
• Helps to ensure all deadlines are met during transition stages.
• Offers education and tutoring to nurses involved in the program. May also provide education to all providers if needed.
• Will participate in webinars, conferences, education meetings, and transitional calls.
• Is able to perform a head-to-toe assessment on all patients and performs reassessments as per policy. This includes: pediatric, geriatric, the general patient population, and EMTALA appropriate medical screening exams.
• Have a solid understanding of the CCM program.
• Revises Care Plans as indicated by the patient’s response to treatment and provider direction.
• Performs patient care responsibilities considering needs specific to the standard of care for patient’s age.
• Is knowledgeable of medications and their correct administration based on age of the patient and their clinical condition.
• Follows the five medication rights and reduces the potential for medication errors.
• Wears identification while on duty, uses computerized punch time system correctly.
• Completes in-services and returns in a timely fashion.
• Attends annual review and department in-services, as scheduled.
• Attends at least 75% of staff meetings annually.
• Represents the organization in a positive and professional manner.
• Actively participates in performance improvement and continuous quality improvement (CQI) activities.
• Solid understanding of the ACO.
• Complies with all organizational policies regarding ethical business practices.
• Flexible in scheduling, work weekends and holidays and work overtime when needed.
• Maintain flexibility in a growing environment and be willing to grow, change and accept new duties as the scope of our department changes with the needs of the community and hospital.
• Solid understanding of HCC coding and quality measures for all payors.
• Training in, understanding of, and utilization of motivational interviewing during interaction with patients.
• Understands care gap rosters and Optum.

Qualifications

• Medical Assistant Certification or Practical Nurse License
• 6 months required experience, 2-5 years clinical experience preferred.
• Experience with Word, PowerPoint, Excel, Microsoft Office, and various EMR systems
• Ability to read and interpret documents such as quality measure implementation guidelines and requirements as well as utilization reports.
• Ability to write routine reports and correspondence.
• Ability to speak effectively before groups or employees of the organization.
• Must be patient, courteous, compassionate, and respectful with patients and their families, co workers, physicians and administrative staff.
• Ability to communicate medical terminology and relate well with physicians, staff and management
• Must be able to handle conflict issues with both patients and staff.
• Must follow established recommendations and guidelines. Must meet deadlines as needed.
• Can concentrate for long periods of time in order to complete assigned tasks with a better than average attention span in order to listen, read and remember verbal and written instructions. Can understand input from the supervisor and/or manager concerning errors and instructions. Ability to deal with problems involving several concrete variables in standardized situations. A clear understating of the importance of patient confidentiality and sensitivity regarding complex health problems. Ability to use critical thinking skills to assess patients and intervene as needed within scope of practice

Job Type: Full-time

Pay: From $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

Work Location: In person

Salary : $20