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Patient Care Coordinator
2 months ago
The Care Coordinator plays a vital role in advancing Mountain View Hospital's objectives towards clinical integration and accountable care models aimed at achieving the triple aim in healthcare: enhancing quality and patient satisfaction, improving health outcomes, and minimizing overall care costs.
Key Responsibilities:
1. Collaborate closely with the nursing supervisor to deliver exceptional patient care.
2. Engage in the clinic's transition to Accountable Care Organization (ACO) and Patient-Centered Medical Home (PCMH) models.
3. Work with the population health team on quality improvement initiatives.
4. Identify and address barriers to effective program implementation.
5. Generate reports to monitor MIPS and ACO performance metrics.
6. Conduct outreach reporting for Chronic Care Management (CCM) and Annual Wellness Visits across all clinics.
7. Monitor high-risk patients and coordinate follow-ups with clinic staff.
8. Ensure compliance with deadlines during transitional phases.
9. Provide education and training to nursing staff and other providers as necessary.
10. Participate in educational webinars, conferences, and transitional meetings.
11. Conduct comprehensive assessments on patients and perform reassessments as per established protocols.
12. Revise care plans based on patient responses and provider guidance.
13. Maintain knowledge of medications and their appropriate administration based on patient age and condition.
14. Develop teaching plans tailored to patient learning needs, involving family members when appropriate.
15. Uphold patient dignity and respect, addressing psychosocial, cultural, and spiritual needs.
16. Facilitate communication between administration, patients, and healthcare providers.
17. Document patient care in accordance with current standards and policies.
18. Ensure patient confidentiality and adhere to regulatory requirements.
Qualifications:
Education/Certification: Must possess a Certificate in Medical Assisting (CMA), a Practical Nursing license (LPN), or a degree in Registered Nursing (RN). A current Idaho license is required. Certification in Care/Case Management or Population Health Management is preferred or must be obtained within three years of hire.
Experience: Preferred candidates will have experience in both inpatient and outpatient settings, with a strong background in Care/Case Management and Population Health Management.
About Mountain View Hospital:
Mountain View Hospital and its affiliated clinics are dedicated to delivering compassionate, innovative care to the community. Our diverse medical services range from urgent care to specialized therapies, ensuring a supportive and mission-driven work environment.
