What are the responsibilities and job description for the Member Care Coordinator position at Piedmont Health Services?
Job Description
Job Description
About Piedmont Health Services
Piedmont Health Services, Inc. (PHS) is a 501(c)(3) nonprofit and Federally Qualified Health Center (FQHC) in North Carolina. Dedicated to delivering top-tier, accessible, and inclusive primary healthcare, PHS has proudly served for 54 years and remains the largest community health center in central NC. Operating 10 Community Health Centers, two PACE (Program of All-Inclusive Care for the Elderly) Senior Care facilities, and 2 Mobile Health Units, PHS extends its services to residents across five counties, including Alamance, Caswell, Chatham, Orange, and Lee.
PHS has been committed to helping change the lives of everyone in our communities, whether that's through our medical services, dental care, on-site pharmacy, nutrition counseling or disease management. With ten (10) CHCs, two (2) PACE Senior Care sites, and one (1) operating Mobile Health Unit, and one (1) under construction, the health of our community members in the Piedmont region is our top priority. Our designated service areas are Alamance, Caswell, Chatham, Lee, Orange, Person, and Randolph counties. We are the healthcare home to over 46,000 patients.
At Piedmont Health Services, we see every day as a chance to create positive impact. We have found that by consistently following and demonstrating our core principles centered on shared commitment, collaboration, open communication, inclusion, and integrity, amongst our patients and our care team, we support the people of our communities in a compassionate, supportive way. We also offer a broad range of outstanding benefits. Participant.
Job Title – Member Care Coordinator
Department – Care Manager
Reports to – Chief Compliance and Quality Officer
Benefits -
Medical, Dental, Vision, Life Insurance (Short & Long Term Disability)
403(b) Plan
Paid Holidays
CME (Continuing Medical Education)
About Position : The Care Manager provides care coordination and case management services to patients at Piedmont Health Services, including social determinants of health needs, identification and linkage to resources, care coordination, chronic disease management, financial assistance, healthcare coordination, and outreach to patients. This role works in collaboration with the Care Management team to support the multi-disciplinary approach of patient care by closing care gaps, reducing hospitalizations, readmissions, and emergency department utilizations. The Care Manager ensures excellence in patient care to achieve optimal clinical outcomes through a seamless model of access and care. Patient base is sub-optimal users of healthcare and / or management of chronic diseases, and individuals with identified social determinants of health barriers. This position will assess any barriers to proper utilization, helps determine best steps to follow treatment recommendations, and provides resource / benefit education on self-care to patients. The Care Manager will assist the team in managing transitions of care for patients following acute care encounters and is responsible to improve patients' health outcomes. Other duties, as assigned.
Work Location : Charles Drew
221 North Graham-Hopedale Road Burlington, NC 27217
Schedule : Monday - Friday : 8 : 00 am - 5 : 00 pm
Required Travel : None(subject to change)
Duties / Responsibilities –
Receives and documents all referrals from various sources into the Care Management documentation platform.
Documents all contacts and interventions within the patients' charts in the electronic medical record.
Identifies social determinants of health opportunities and ensures linkage to resources.
Refers patients and families to appropriate community agencies or facilities, acts as liaison to these organizations, and is an advocate for patients.
Assists with outreach, engagement, and coordination of interventions for Transition of Care for patients.
Assists with coordination of placement for different levels of care for patients.
Assists with coordination of specialty and primary care appointments to include scheduling and confirmation of appointments.
Obtains and uploads documents into the care management database.
Assists with care gap assessments and closures.
Provides outreach to help patients manage chronic health conditions. Assists with the plan of care.
Provides assessments and screenings for health concerns.
Assists patients with care coordination and healthcare system navigation.
Engages in interdisciplinary team meetings to discuss patients plan of care.
Provides culturally appropriate health education and information.
Ensures linkage to registries and waiting lists are completed for any community resources.
Submits supplemental data to health plans to provide documentation of gap closure.
Schedules medical appointments and transportation.
Collaborates with the care team to address barriers and creates efficient processes.
Ensures urgent issues are shared with care team.
Participates in all assigned meetings.
Adheres to privacy and security policies to ensure patient and company data is properly safeguarded. Follows company policies and HIPAA regulations.
Meets productivity and role expectations, and addresses requests in a timely manner. Other duties, as assigned.
Population Served –
Pediatric, Adolescent, Adult, Geriatric, Prenatal. Diverse population including but not limited to chronically ill and limited English speaking patients.
Qualifications –
Required : High School diploma, or equivalent, required
2 years of experience in a healthcare organization
Preferred : Bilingual Required
Bachelor's degree in social work, healthcare administration, human services, public health or related field, preferred.
One to two years nursing, case management, or social work experience.
Education : High School diploma, required
Pay Range - $20.48 - $27.52
EEO Statement
Piedmont Health Services, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to sex, sex stereotyping, pregnancy (including pregnancy, childbirth, and medical conditions related to pregnancy, childbirth, or breastfeeding), race, color, religion, ancestry or national origin, age, disability status, medical condition, marital status, sexual orientation, gender, gender identity, gender expression, transgender status, protected military or veteran status, citizenship status, genetic information, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
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Salary : $20 - $28
