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Care Coordinator
3 months ago
Job Type
Full-time
Description
This position will office in Glenwood at the CHI clinic. There will be required travel to the CHI Murfreesboro and CHI Mount Ida which will be limited to a couple of days each month.
Job Description:
- Collaborates with providers and other members of the healthcare team to identify targeted patient populations within the practice site(s).
- Assesses the health care, educational, and psychosocial needs of the patient/family utilizing standardized assessment tools such as depression screening, functionality, and health risk assessment.
- Collaborates with providers, patients, and other members of the health care team to monitor the status of individualized plans of care and assist with targeted interventions as appropriate.
- Provides patient self-management support with a focus on empowering the patient to achieve optimal health and independence.
- Facilitates clinical interventions based on protocols and evidence-based clinical guidelines.
- Fosters a team approach and includes patients and their families/caregivers as active members of the team.
- Completes timely follow-up with patients discharged from the ED or Inpatient setting: Follow-up may include reviewing discharge instructions and medications, scheduling PCP or specialist follow-up appointments, coordinating necessary services/additional care/equipment/etc. during transitions of care, and problem-solving barriers.
- Demonstrates critical thinking skills, as well as positive relationship-building communication skills (both written and verbal).
- Maintains required documentation for all patient outreach and care coordination activities.
- Works with practice and leadership to continuously evaluate processes, identify problems, and propose/develop process improvement strategies to enhance care coordination services.
- Demonstrates customer-focused interpersonal and communication skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, patients, and families/caregivers.
- Demonstrates ability to work autonomously and be directly accountable for assigned duties.
- Demonstrates time management, priority setting, and work organization skills.
- Demonstrates ability to function effectively in a fluid, dynamic, and rapidly changing environment.
- Current Medical Assistant Certification and/or Registration or Current LPN license
- Previous care of patients in primary/ambulatory care or other healthcare facilities, in the past five years
- Critical thinking skills and ability to analyze data
- Excellent verbal and written communication skills
- Excellent interpersonal and facilitation skills.
- Ability to affect change, work as a productive and effective team member, and adapt to changing needs/priorities
- Demonstrates excellent time management, priority setting, work delegation, and work organization skills
General computer knowledge and capability to use various computer programs.
