The Care Coordination Manager is a working Care Coordinator who leads the Care Coordination program. They delegate tasks based on resources and needs, ensure there is adequate clinic coverage and monitor MHN ACO performance indicators. They are also involved in organization-wide needs that may come ad hoc based on grant funding or other sources.

Essential Duties and Responsibilities:

• Collaborates with population health department on initiatives
• Acts as peer support for enrolled patients which includes advocacy as patients navigate the medical system and relationship building with individuals and their families
• Administers the Health Risk Assessment
• Connects patients to resources for unmet social needs
• Reports any health care challenges identified to the Care Manager
• Maintains and distributes approved disease specific education to identified patient panel and community
• Provides reminder phone calls for various scheduled appointments or follow-up after scheduled appointments
• Assists patients with obtaining specialty care visits, Primary Care Provider visits, and ancillary services such as labs/diagnostics, including making appointments as needed
• Enters and maintains electronic records, compiles reports and complete other program documentation in a timely manner (e.g. progress notes, incident reports, client track, letters, etc.); other administrative responsibilities as needed
• Obtains copy of medical records such as continuity of care documents, discharge summary or discharge information from Primary Care Provider, hospital case manager or discharge planners and others involved in patient's care.
• Handles protective health information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPPA)
• Other duties as assigned 

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Required Education and/or Experience:

• High school diploma or equivalent.
• Three years of experience in healthcare or public health.
• Electronic medical record experience.

Preferred Education and/or Experience:

• Associate or bachelor’s degree.

Language Skills:

• Bilingual skills highly desired and always preferred.

Additional Qualifications:

• Highly energetic, motivated, resourceful, and self-directed.
• Must have flexibility to manage multiple tasks simultaneously.
• Ability to work collaboratively in team environments.
• Strong interpersonal and organizational skills.