Patient Care Coordinator
4 weeks ago
Job Summary:
The Patient Care Navigator is a vital role within our organization, responsible for facilitating the delivery of information to individual members of the clinical team to help coordinate prescribed healthcare services. This position serves as a liaison between beneficiaries/members and healthcare components, ensuring seamless care transitions and improved patient outcomes.
Key Responsibilities:
- Increases beneficiary/member involvement in the decision-making process.
- Minimizes fragmentation of care within the healthcare delivery system.
- Assists in improving adherence to the plan of care for the beneficiary.
- Acts as an advocate for the beneficiary/member.
- Collaborates with clinical teams to focus on moving the beneficiary/member to self-care (independence) whenever possible.
- Coordinates care for the beneficiary/member, including chronic care management and transition care management.
- Participates in team meetings and quality improvement initiatives.
- Focuses on transitions of care, ensuring safe, effective, and timely transfers between care settings.
- Collaborates with outpatient staff to ensure safe transitions and follow-up with primary care physicians and/or specialists.
- Improves outcomes by utilizing adherence guidelines, standardized tools, and proven processes to measure beneficiary/member understanding and acceptance of proposed plans.
- Facilitates health and disease beneficiary/member education.
- Coordinates with clinical teams to move beneficiaries to optimal levels of health and well-being.
- Improves beneficiary/member safety and satisfaction with their healthcare needs.
- Expands the interdisciplinary team to include beneficiary/member and/or their identified support system, healthcare providers, and community-based professionals.
- Improves beneficiary/member experience by coordinating appointments and referrals with specialists using our Preferred Provider Network.
- Maintains a daily census of beneficiaries/members' admissions, discharge dispositions.
- Demonstrates proficiency with electronic medical records and care coordination systems.
- Documents all interactions between beneficiary/member/caregiver and all components of the healthcare delivery system.
- Adheres to all policies and procedures, including the HIPAA Privacy rule.
Requirements:
- High School diploma
- Driver's license
- Preferred one (1) year of outpatient or inpatient care setting experience
- Fully bilingual preferred (English/Spanish)
Knowledge, Skills, and Abilities:
- Knowledge with Care Coordination of the elderly
- Ability to work with a high attention to detail
- Compassion and empathy
- Strong communication and interpersonal skills; both written and oral
- Proficiency with electronic healthcare records systems
- Proficiency in Excel and Word
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