Clinical Care Coordinator

4 weeks ago


San Antonio, Texas, United States CommuniCare Health Center Full time
Clinical Care Coordinator - LVN

As a licensed LVN Clinical Care Coordinator at CommuniCare Health Center, you will play a vital role in navigating the care of complex or high-risk patients. Your responsibilities will include responding to patient calls, providing health education, and collaborating with multidisciplinary care teams to ensure seamless patient care.

Key Responsibilities:
  • Coordinate patient care as determined by the provider, working closely with the provider and clinic staff to identify patients with high-risk diagnoses and ensure clinical guidelines are being followed.
  • Work with the Navigation and Innovation Center to answer patient calls regarding clinical questions for clinical care coordination team patients within their scope of practice.
  • Contact patients directly regarding concerns/clinical questions brought forth by the patient or provider, ensuring that patients are made aware of health issues, concerns, and the way in which one could combat them.
  • Available to coordinate resources for high-risk/poor compliance patients as determined by the primary provider.
  • Collaborate with primary provider and specialty services to optimize patient care and the patient experience.
  • Contact CommuniCare post-hospitalization, post-ER, and postoperative patients regarding patient status and schedules appropriate follow-up with CommuniCare.
  • Reviews no-show list and contacts patient regarding status and clinical plan.
  • Assists, initiates referrals, and coordinates transitions of care regarding hospitalization follow-up, palliative care, hospice, etc. Maintains knowledge of specialty and ancillary provider contract contents, to include exclusions and contract terms.
  • Enters timely and accurate data into the electronic medical record to communicate patient needs and to ensure complete documentation of patient visits and phone calls.
  • Provides exceptional customer service internally and externally, greeting each customer with an appropriate introduction, addressing concerns prior to the end of the interaction, and assisting other departments as appropriate.
  • Performs other related duties as assigned.
Requirements:
  • Graduated from an accredited school of vocational nursing required.
  • Current unrestricted Texas LVN/LPN license required.
  • Two (2) years' experience in a primary health care setting required.
  • Experience with EMR/EHR preferred.
  • Ability to plan, organize, and perform well under stress.
  • Bilingual in English and Spanish preferred.
  • Sensitive to the needs of the Center's target population.
  • Certified in Basic Life Support (BLS), American Heart Association required.
  • Knowledge of personal computers to include internet/intranet navigations.
  • Scheduled hours and/or work locations are subject to change.


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