Healthcare Coordination Specialist

2 weeks ago

Murfreesboro, Tennessee, United States Primary Care and Hope Clinic Full time

Reports To:
Care Coordination Manager

Employee Status:
Non-Exempt (Regarding Overtime)

Position Summary:
The Healthcare Coordination Specialist collaborates with Primary Care & Hope Clinic Medical and Behavioral providers, as well as external healthcare professionals, to assist patients and their families in navigating their healthcare journey.

Essential Functions:

Care Coordination:
Serve as a representative of PC&HC to patients and visitors, ensuring a compassionate, courteous, and professional experience. Deliver prompt, efficient, and accurate patient services.

Execute health insurance enrollment tasks, including responding to inquiries, generating interest through outreach, providing application assistance, and documenting activities related to access, utilization, and retention.

Evaluate the physical, functional, social, psychological, environmental, and financial needs of clients/patients; devise a comprehensive, cost-effective plan to address the healthcare needs of families and implement this plan.

Assess the client's formal and informal support systems.

Offer consultations to patients, providing education on both acute and chronic illnesses under the guidance of a Medical Doctor or Nurse Practitioner.

Advise patients on preventative health maintenance, which includes annual examinations, diagnostic screenings, immunizations, and nutrition.
Encourage timely access to appropriate care, enhance the use of preventative services, reduce emergency room visits and hospital readmissions, and improve understanding through culturally and linguistically appropriate education. Develop and promote adherence to a care plan created in collaboration with the patient, primary care provider, and family/caregiver(s).

Enhance continuity of care by managing relationships with tertiary care providers, facilitating transitions-in-care, and coordinating referrals. Empower patients to engage in self-management and shared decision-making. Conduct medication reconciliation and connect patients with relevant community resources to improve health outcomes, increase patient satisfaction, and lower healthcare costs.
Referral Program:
Make timely and appropriate referrals to specialists, durable medical equipment suppliers, or home health agencies as requested by providers.
Initiate the referral process by contacting insurance carriers.
Stay updated on insurance pre-authorization requests.
Respond promptly to patient inquiries regarding the referral process.
Compile all necessary medical data and documentation, ensuring it is sent to the appropriate recipients.
Act as a liaison between the practice, patients, and referral sources, addressing any complaints or issues.
Organize and prioritize workload to maintain efficient patient operations within the health center.

Marginal Functions:

Enhance the patient experience and healthcare processes, ensuring the delivery of high-quality care and ongoing performance improvement.

Complete all required documentation and perform additional duties as assigned.

Requirements:
Bachelor's degree in Social Work, Community and Public Health, or a related field is preferred.
Certification as a Certified Application Counselor for health insurance enrollment is required.
Knowledge of teaching principles and methods for individuals and groups is essential.
Ability to communicate with patients in a friendly and positive manner is necessary.
Proficiency in operating office-related equipment is required.
Compliance with HIPAA and OSHA regulations is mandatory.
This document outlines the general nature and level of work performed and is not intended to be an exhaustive list of all duties, skills, and responsibilities required of personnel in this classification. Responsibilities, knowledge, skills, abilities, and working conditions may evolve as needs change.

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