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Care Coordinator

2 months ago

Houston, Texas, United States Su Vida Services Inc Full time
About the Role

The Care Coordinator will play a pivotal role in delivering high-quality care to our patients at Suvida Healthcare. Working closely with the Nurse Care Manager, the Care Coordinator will be responsible for conducting daily patient follow-ups, processing durable medical equipment (DME) and home health orders, triaging calls, retrieving hospital records for recently admitted patients, and performing other clinical clerical tasks within the scope of practice for high-risk patients.

Key Responsibilities
  • Conduct Daily Patient Follow-Ups: Conduct daily patient follow-ups for high-risk patients within the Chronic Care Program to ensure timely and effective care delivery.
  • Process DME and Home Health Orders: Process DME and home health orders efficiently and accurately to ensure seamless care delivery.
  • Triage Calls: Receive inbound triage calls from patients and coordinate appropriate responses to acute patient needs.
  • Retrieve Hospital Records: Retrieve hospital records for patients recently admitted to external facilities to ensure accurate and comprehensive care delivery.
  • Perform Clinical Clerical Tasks: Perform clinical clerical tasks to support the Chronic Care Program and Transition of Care Programs.
  • Assist in Procedures: Assist in procedures within the Medical Assistant scope of practice for high-risk patients.
  • Collaborate with Nurse Care Manager: Collaborate closely with the Nurse Care Manager to ensure seamless patient care delivery.
  • Identify and Address Barriers to Care: Identify and address barriers to care for high-risk patients to ensure timely and effective care delivery.
  • Coordinate Patient Care Progression: Coordinate patient care progression throughout the continuum, including transitions from acute and post-acute settings to home or other transitional care facilities.
  • Communicate Effectively: Communicate effectively with physicians, nursing staff, and other members of the multidisciplinary care team.
  • Facilitate Patient Discharge Planning: Facilitate patient discharge planning process to optimize outcomes and satisfaction.
  • Monitor Patient Progress: Monitor patient progress and intervene as necessary to ensure patient-focused, high-quality care.
  • Collaborate with External Case Managers: Collaborate with external case managers and community resources as needed.
  • Participate in Clinical Performance Improvement Activities: Actively participate in clinical performance improvement activities to ensure high-quality care delivery.
  • Support Activities to Promote Closure of Care Gaps: Support activities to promote closure of care gaps and attainment of Medicare HEDIS metrics.
Requirements
  • Minimum 2 Years of Experience: Minimum 2 years of experience as a Medical Assistant or a LPN/LVN.
  • Experience in Chronic Care Management: Experience in chronic care management or related field preferred.
  • Excellent Interpersonal and Communication Skills: Excellent interpersonal and communication skills.
  • Strong Organizational and Time Management Abilities: Strong organizational and time management abilities.
  • Proficiency in Microsoft Office Suite: Proficiency in Microsoft Office suite.
  • Bilingual/Bicultural: Bilingual/Bicultural (English and Spanish) required.