Primary responsibilities include participating in chronic disease management education, participating in data entry and manipulation to monitor performance improvement initiatives and working with leadership to improve access to health services, particularly for the uninsured. Care Coordinators achieve these goals by working with our patients to identify and modify psychological, behavioral, emotional and social factors important to maintenance of their holistic health and their ability to access care.
Ensures the delivery of exceptional customer service by putting all customers (internal and external) first and displaying:
A healing focus
A selfless heart
A tireless resolve
MAJOR DUTIES AND RESPONSIBILITIES:
Provides service for patients of adult and geriatric age groups.
Healthcare Effectiveness Data and Information (HEDIS) Champion
Pre-visit record planning – ID HEDIS reminders, DXs to be updated, follow-up on diagnostic and consultation reports
Responsible for referral and pre-authorization coordination. Coordinates patient appointments with network providers and follow up with providers to obtain timely reports.
Provide patient education using and discuss self–management goals with the patient and assists them in selecting appropriate goals to create an action plan
Monitor and document goals selected and follow-up with patient by phone, email or in person to determine if goals are achievable and provide assistance to the patient when needed in how to achieve their goals.
Facilitates disease management support groups.
Facilitate connections to community support groups and resources
Maintains a wellness bulletin board
Maintains contact with patient while hospitalized
Post discharge plan and follow-up and coordination.
Maintains a safe environment of care for patient and staff by reporting any unsafe condition, equipment, or activities to the appropriate personnel.
Participates in multi-discipline team conferences and mandated service training programs.
Participates in the development and implementation of corrective action plans to address departmental and operational deficiencies
Identifies and reports equipment and information systems malfunction with the IT Department.
Checks and maintains adequate amount of equipment and supplies.
Maintains records and correspondence in orderly well kept files
Informs supervisor of any management or operating problems that may affect quality and standards of patient services.
Provides comprehensive monitoring of all patient cases to ensure timely and thorough medical treatment and access.
Demonstrates respect for the privacy and confidentiality of patient’s medical records and visits.
Frequent contact with patients, colleagues and outside agencies
Frequent exposure to communicable diseases and other conditions common to a health center environment – High Risk OSHA category.
Requires adherence to Infection Control Standard Precautions.
Fluency in both English and Spanish a plus
Medical coding experience a plus
Proven experience in verbal and written communication and case management service skills
Proven ability to function effectively as a member of an interdisciplinary team
Effective communication and interaction with employers, patients, providers, and other colleagues.
Working knowledge of clinical operations and/or utilization management.
Basic knowledge of HEDIS/CMS Stars.
Competent computer skills required
Ability to write read and understands instructions, add, subtract, multiply and divide number using whole number, common fractions and decimals.
Requires the ability to compute rate, ration and percent and to draw and interpret bar graphs.
Establish and maintain working relationship with all levels of colleagues.
Above average organizational skills.
Excellent customer service skills.
Ability to exchange information on factual matters, schedule appointments, greet patient, explain policies of the facility and/or relay patient’s needs to appropriate personnel.
Role requires providing direct patient care to adult and geriatric patients.
Concentra Inc. - 2 years ago
Concentra Managed Care, Inc. is the leading provider of healthcare management and cost containment services to the workers' compensation,...