Care Specialist Coordinator

6 days ago

Brentwood, California, United States Upward Health Full time

About Upward Health

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At Upward Health, we're dedicated to providing exceptional care and support to those who need it most. As a Care Specialist Coordinator, you'll play a vital role in our mission by delivering chronic care management to high-complexity patients in their homes and communities.

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Job Summary

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We're seeking a highly skilled and compassionate individual to join our team as a Care Specialist Coordinator. In this role, you'll work closely with patients, families, and healthcare providers to develop and implement personalized care plans that promote timely access to appropriate care, increase utilization of preventative care, reduce emergency room utilization and hospital readmissions, create and promote adherence to a care plan developed in coordination with the patient, primary care provider, and family/caregiver(s), increase patient's ability for self-management and shared decision-making, provide medication reconciliation, connect patients to relevant community resources, with the goal of enhancing patient health and well-being, increasing patient satisfaction, and reducing healthcare costs.

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Responsibilities

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  • Conduct direct outreach to patients via phone, in-person, mailings, and other strategies including cold calling and unscheduled door knocks.">
  • Enroll patients into Upward Health's program and collect key data about patients during the enrollment process through continuous and on-going phone and in-person interactions.">
  • Meet patients in their home or in the community to conduct a needs assessment, including helping patients to set health goals.">
  • Coordinate care between patients and interdisciplinary care teams as needed.">
  • Support your patients in meeting their healthcare goals as it relates to Quality measures.">
  • Work within an interdisciplinary team to support the team's effort in meeting market and/or organizational goals.">
  • Analyze patient data to determine patient needs or treatment goals.">
  • Assess physical conditions of patients to aid in diagnosis, treatment; and/or need for additional referrals in support of health and social needs.">
  • Explain technical medical information to educate the patients.">
  • Cultivate and support the primary care providers with timely communication, inquiry follow-up, and integration of information into the care plan regarding transitions-in-care and referral.">
  • Builds rapport with Upward Health patients utilizing motivational interviewing techniques.">
  • Conduct one-on-one extended in-person patient appointments.">
  • Makes follow-up calls and home visits to patients per Upward Health policy.">
  • Documents each patient encounter with accuracy and precision.">
  • Prepares reports and documents as needed or requested.">
  • Attends regular daily huddle, team meetings and participates in clinical rounds.">
  • Other duties as needed.">
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Requirements

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  • At least 2 years of relevant work experience as a Community Health Worker, Peer Support Specialist, Medical Assistant, or similar role.">
  • High school graduate or GED required.">
  • A valid driver's license and auto liability insurance.">
  • Reliable transportation and the ability to travel within your assigned territory or other as needed to support the patient needs plan and training requirements.">
  • Experience in Chronic Care Management model OR experience with chronically ill/elderly patients.">
  • Long-time resident of the community with good knowledge of the resources of this community.">
  • Ability to complete Upward Health's initial training program and ongoing educational requirements as assigned, both virtually and in-person.">
  • Technologically savvy with basic computer skills, including ability to type.">
  • Multi-lingual capabilities preferred, but not required.">
  • Prior Home Care experience a plus.">
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Compensation

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$56,800 - $65,760 per year, based on qualifications and location.

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About You

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We're looking for someone who is passionate about delivering exceptional care and making a positive impact in the lives of others. If you possess strong critical thinking skills, are a self-starter with the ability to work independently in an unstructured environment, and have excellent communication and interpersonal skills, we encourage you to apply for this exciting opportunity.

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Join Our Team

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We offer a dynamic and supportive work environment that values diversity, equity, and inclusion. If you're ready to take on new challenges and make a difference in the lives of our patients, please submit your application.

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