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Patient Health Advocate
2 months ago
Somatus, Inc. is seeking a highly motivated and compassionate Patient Health Advocate to support patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) in managing their care needs.
Key Responsibilities- Develop and Implement Care Plans: Work under the guidance of physicians and/or a nurse care manager to create and implement individualized care plans for patients with CKD and ESKD.
- Establish Positive Relationships: Establish positive, supportive relationships with patients and their families to promote health literacy and self-management skills.
- Conduct Initial Triage Assessments: Conduct initial triage assessments to identify patients' needs and connect them with appropriate resources and services.
- Document Patient Activities: Document patient activities and care plan progress in our care coordination platform.
- Address Language and Cultural Barriers: Engage with patients to address language and cultural barriers to care management and self-care.
- Coach and Guide Patients: Coach and guide patients to meet personal and clinical goals, including scheduling appointments and accompanying patients to appointments when needed.
- Remind Patients of Upcoming Appointments: Remind patients of upcoming appointments and help them access community and government-based services.
- Teach Caregivers: Teach caregivers about symptom response plans and arrange transportation as needed.
- Closing Gaps in Care: Closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing.
- Assist with Educational Resources: Assist patients with enrolling in educational videos and participate in integrated care team meetings.
- Experience Working with Vulnerable Populations: Experience working with Medicare, Medicaid, or Special Needs populations.
- Medical Background or Experience: Medical Assistant, Licensed Practical Nurse, Engagement Specialist, or Community Health Worker experience.
- Strong Communication Skills: Ability to connect with people and understand the challenges they face.
- Outreach and Engagement: Ability to use a range of outreach methods to engage individuals and groups in diverse settings.
- Community Knowledge: Well-connected to the community and resources within the community they will serve.
- Effective Communication: Effective written and verbal communication skills demonstrating respect and cultural awareness during interactions with clients.
- Travel and Home Visits: Ability to travel throughout the assigned region and comfort with conducting home visits (50-75% same day travel).
- Experience with Chronic and Behavioral Health Needs: Experience working with patients with chronic and behavioral health needs.
- Teamwork and Communication: Demonstrated success in working as part of a multi-disciplinary team, including communicating and working with physicians and registered nurses.
- Engagement and Motivation: Proven experience with engaging patients in making healthy behavior changes.
- Navigating the Healthcare System: Proven skills in navigating the healthcare system and making necessary linkages to meet specific needs.
- Electronic Medical Records: Experience working with Electronic Medical Records and other documentation platforms.
