Care Coordinator

Medical Home Care Coordinator
Job Title: Medical Home Care Coordinator
Position: Full-time
General Description:
The Medical Home Care Coordinator (MHCC) works on a multidisciplinary healthcare team in a pediatric primary care setting. S/he will focus on developing a care plan addressing social, financial, and behavioral barriers to care for patients/families/caregivers identified at greater risk for poor outcomes. The MHCC will also have a lead role within the practice in order to provide patients and families/caregivers optimal care coordination services as indicated.
Summary of Duties:
Medical Home:
 Work alongside pediatric primary care providers and practice staff to identify patients with complex needs
 Provide support to high risk patients including management of multiple conditions to reduce avoidable admission/readmission to a hospital setting
 Build and maintain relationships with community-based agencies and resources to facilitate access to necessary services
Care Coordination
 Coordinate services and follow-up for patients/families/caregivers with social barriers to care
 Assist patients/families/caregivers with navigating the healthcare system and promote patient/family/caregiver self-care and advocacy
 Promote clear communication amongst patients/families/caregivers and the care team through integrated care planning, team meetings and collaboration with community-based agencies
 Coordinate appropriate follow-up for patients and families following a transition of care, such as a hospital admission/discharge, emergency room visit, or specialist visit
Quality Improvement
 Collaborate and assist the practice in developing a process for population health management
 Participate in quarterly Medical Home Care Coordinator Longitudinal Meetings
 Collaborate around data collection, health outcomes reporting, clinical audits, and programmatic evaluation(s) related to the Medical Home Care Coordination program
Minimum Qualifications:
 Experience with care management, care coordination or community health worker services in a primary care setting
 Ability to take and follow-through with delegated tasks and accountability
 Experience with and comfortable working on a team
 Critical thinking and problem solving skills
 Data analysis skills
Preferred Qualifications:
 RN with experience in a health care setting; Associate’s degree in a health related field or LPN with experience in a primary care setting
 3-5 years of experience working with children and families with complex medical and behavioral health conditions
 Prior experience with Electronic Medical Record(s)

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

COVID-19 considerations:
All staff and patients are required to wear masks, all surfaces are sanitized daily.

Education:

• Associate (Preferred)

Experience:

• Customer service: 3 years (Preferred)

Work Location:

• One location

Work Remotely:

• No

Work Location: One location