Patient Care Coordinator

1 week ago

Escondido, California, United States Neighborhood Healthcare Full time
About Us

At Neighborhood Healthcare, we're dedicated to improving the health and happiness of the communities we serve. Our mission is to provide quality care to all, regardless of situation or circumstance.

Job Overview

The Patient Care Coordinator plays a vital role in supporting our Primary Care Practice teams to improve patient health outcomes. This role involves coordinating and providing panel management services to patients at highest risk for health deterioration, as well as assisting patients in achieving their self-care goals by increasing access to health services and resources.

Responsibilities
  1. Utilize the primary care medical home model to provide coordinated team care to address current diseases.
  2. Provide panel management for preventative and health maintenance follow-ups for the maximum number of patients per day.
  3. Contact new patients to provide a warm welcome to our clinic, explain the medical home, and answer patient questions.
  4. Schedule patients with chronic conditions for follow-up appointments per preventative and maintenance care schedules.
  5. Perform population management tasks, such as appointment scheduling, recalls, web portal callbacks, and addressing telephone encounters.
  6. Make outreach calls to patients missing appointments based on preventative and chronic disease guidelines.
  7. Delegate ECW telephone encounters and Web Portal messages to medical assistants and providers.
  8. Implement actions for increasing productivity, such as scheduling patients for PCP follow-up visits, anticipating open slots for same day appointments, and proactively maintaining full provider schedules.
  9. Track and report the progress of assigned tasks and logged PCP discussion topics in weekly supervisor meetings.
  10. Collaborate and support the PCP to identify and implement actions for improving population management and patient care outcomes.
  11. Organize weekly pre-clinic team huddles to update progress on various goals, such as Meaningful Use compliance and C.A.R.E. Transformation.
  12. Coordinate monthly medical assistant team meetings to discuss progress towards PCMH goals and areas needing improvement.
  13. Provide and document patient end-of-visit interviews, coaching, and patient engagement conversations.
  14. Reinforce information given to patients and/or family with handouts to improve patient self-management skills and communication.
  15. Provide education to patients during medical appointments, as needed.
  16. Act as first point of contact for patients and families asking questions and raising concerns through the patient web portal and via phone.
  17. Submit prior authorization for medications, DME supplies, and other items, as needed.
  18. Impact patient experience by demonstrating values of Transforming Care, including courteous and helpful behavior and a commitment to accuracy.
  19. Share accountability for overall patient health outcomes by working in coordination with PCP.
  20. Complete ECW notes for all care coordination and other services provided in a timely manner.
  21. Prioritize activities according to need and required follow-up.
  22. Provide accurate and timely reports to supervisor, as required.
  23. Contribute to the success of the organization by participating in quality improvement activities.
  24. Operate to instill confidence in our care and in our facilities to patients, fellow employees, and other stakeholders.
  25. Assist medical assistant and patients as needed.
Requirements

We're looking for a highly skilled and compassionate individual to join our team. The ideal candidate will have:

  • A high school diploma or GED.
  • A Medical Assistant Certificate from an accredited program.
  • Valid AHA (American Health Association) BLS certification.
  • At least one year of medical assistant experience within a medical home health setting.
  • Non-profit community health clinic experience is a plus.
  • Bilingual (English/Spanish) is highly preferred.
  • Diabetes and hypertension education experience is a plus.
What We Offer

We offer a competitive salary range of $23.78 to $30.07 per hour, depending on experience. If you're passionate about improving the health and happiness of our communities, we'd love to hear from you.

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