Care Coordinator Field (MA)

Intrinsia Health creates opportunities for providers to improve the care for the seriously ill.

Currently on track to exceed program goals in each of its first 3 years, Intrinsia Health expects to reach 75 markets by January 1, 2026 As the leading growth opportunity for serious illness population management, Intrinsia Health will unite provider practices with payment sources, tools and community resources.

Responsibilities:

• Office duties

• Uploading pertinent documents to the patients EHR
• Verifying Eligibility
• Scheduling ACO Reach patients
• Following up with ACO Reach patients, families, and CGs with orders and results.
• Enter new ACO Reach patients into the EHR
• Creating Super Bills
• Updating Excels and pertinent spreadsheets
• Accessing Acclivity AI tool to check on data, HIE alerts, pull reports, and documenting information.
• Creating orders per Providers documentation
• Perform Prior Authorizations

• Patient Visits:
  • Visit patients and coordinate telemedicine visits for providers.
  • Collect patients vitals, relevant measurements, height, and weight.
  • Obtain updated history and physical (H&P) and clinical documents.
  • Discuss current symptoms and concerns with the patient.
  • Assist providers in assessing patients, including checking for edema, discoloration, wounds, fall assessment, and medication reconciliation.
  • Assist patients with consents, Voluntary Alignment forms, SDOH Tool Checklist, and obtaining identification/insurance card copies.
  • Help with Annual Wellness Visits (AWV), including questionnaires, Health Risk Assessments, and other AWV tasks.
  • Assist with aligning Medicare patients to the ACO Reach program.
  • Opportunity to travel and assist ACO patients contracted in other states.

• Chart Preparation:
  • Update providers on arrival at the patient's home and readiness for telemedicine visits.
• Chart prep the providers notes in the practices EHR.
• Post Visit:

• Update Acclivity on pertinent patient information- outreach calls, patient visits, complete Acclivitys Demographic Assessment and SDOH Screening Tool Checklist.
• Notify team members when visits are not complete- reschedule missed visits immediately after notification.
• Educate families, patients, and caregivers about the ACO Reach Program.
• Communicate accurate and timely information with patients, families/caregivers, providers, and other members of the healthcare team.
• Participate in ACO Reach Interdisciplinary Team meetings.

• Assist providers in incorporating Medicare Approved Benefit Enhancements when applicable.
• Will collaborate and work as a team with the ACO Reach Intrinsia Health staff and with ACO Reach Preferred and Participant Providers.

Qualifications:

• Graduate of a Medical Assistant certificate program required.
• Possesses an ability to maintain good interpersonal relationships with patients, families, co-workers, and other health team members.
• Expert customer service ability and a strong desire to perform as an integral part of the care team