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Healthcare Coordination Specialist
2 months ago
The Healthcare Coordination Specialist is essential in managing care and healthcare services for the Medicare Advantage and ACO patient demographic within a primary care setting. This role involves close collaboration with healthcare professionals to ensure smooth transitions of care and to promote adherence to treatment protocols.
Key Responsibilities:
1. **Care Management Coordination:**
- Collaborate with clinical teams to deliver comprehensive care, including pre-visit preparations and post-visit summaries.
- Engage patients in health improvement initiatives and educate them on self-management to minimize unnecessary emergency department visits and hospitalizations.
2. **Team Collaboration:**
- Facilitate weekly team meetings to analyze population health data, identify high-risk patients, and review utilization trends.
- Actively manage a panel of chronic care patients, anticipating their needs and addressing barriers to care.
3. **Patient Engagement:**
- Work with patients, physicians, and care team members to evaluate progress towards health objectives and ensure accurate documentation of patient self-management efforts.
- Maintain confidentiality and comply with HIPAA regulations while treating all individuals with dignity and respect.
4. **Care Transition Services:**
- Collaborate with healthcare providers to identify patients needing care transition services and support referrals for high-risk patients to the Complex Care Management team.
- Coordinate medication refills and work with the central Medication Adherence team to ensure patients with chronic conditions take their medications as prescribed.
5. **Monitoring and Documentation:**
- Monitor various platforms for patient utilization events, such as hospital admissions and emergency department visits, and document occurrences.
- Conduct transitional care activities, including follow-ups post-hospital visits, medication reviews, and scheduling TCM visits.
6. **Resource Coordination:**
- Manage referrals, prior authorizations, and follow-ups with community resources, ensuring appropriate utilization of services.
- Review and manage home health certifications and discharges with relevant providers.
Qualifications:
- **Preferred:** Active Medical Assistant Certification.
- **Minimum:** One year of medical experience in a physician's office, with a preference for experience in Primary Care and familiarity with value-based care and Medicare Advantage.
- Bilingual candidates are preferred.
Knowledge, Skills, and Abilities:
- Current Basic Life Support Certification.
- Advanced knowledge of medical terminology.
- Support for the practice's mission and goals.
- Bilingual Spanish may be preferred.
Physical Requirements:
- Ability to carry/lift minimal weight.
- Standing and walking for up to 8 hours per day.
- Repetitive motion and visual acuity required for computer work.
- Office environment with necessary accommodations for viewing computer monitors and reading printed materials.
