With over 50 years of service, our goal is to improve the health of the community we serve by creating easier access to quality clinical, preventative, and specialty healthcare services. Watts Healthcare Corporation is deemed by the Bureau of Primary Health Care of the U.S. Department of Health and Human Services to be a federal employee for purposes of medical malpractice claims and, as such, qualified for protection under the Federal Tort Claims Act.
SUMMARY:
Under the direction of the RN Coordinator/Supervisor and Clinic Operations Director, the Chronic Care Coordinator assists in improving the care of patients by increasing engagement between the primary care team and the patient while empowering patients and their families with the information they need to better manage their health.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Utilizes a developed marketing script to enroll eligible Medicare beneficiaries into Chronic Care Management (CCM) Services
- Informs patients of CCM services and obtains informed consent by verbal or written from (Original copy or Patient Portal).
- Schedules initial visit PCP appointment if new or patient has not seen a provider for the last 12 months.
- Calls patients and schedules RN Coordinator appointments after patient visits with PCP.
- Meets and/or follows-up with patients via phone and/or clinic visit to coordinate and/or provide timely direct assistance in meeting the self-management goals identified in the established plan of care.
- Establishes rapport, provides relevant information/guidance and ensures that information is understood by the patient/family.
- Documents all actions taken in eCW.
- Updates provider team(s) on a continuous basis to report patient progress/status, and issues/problems; alerts team to gaps in care and/or patient non-adherence with plan of care.
- Assists the RN Coordinator to identify needs that may impact the patient's health, including transportation and referral issues, financial concerns, end-of-life planning, etc.
- Acts as an advocate for the patient/family by locating appropriate community resources to address concerns and reduce risk of hospitalization.
- Assists the RN Coordinator to monitor effectiveness of services provided by external resources and provides timely feedback to the provider/interdisciplinary team.
- Assists the RN Coordinator to contact patients and make follow-up calls as needed.
- Performs other duties as assigned.
QUALIFICATION REQUIREMENTS:
- Excellent verbal and written communication skills.
- Average knowledge of MS Office programs, such as MS Word, Excel, PowerPoint.
- Ability to interact with all stakeholders in the organization and develop positive relationships while being tactful, respectful and direct in communication.
- Fully fluent in English and Spanish; preferred.
EDUCATION and/or EXPERIENCE:
- 1-3 years of experience in a healthcare or medical setting.
- EHR knowledge (Practice Management and Electronic Medical Records).
- Possess CPR Certificate - sponsored by the American Heart Association or the American Red Cross.
PREFERRED:
- Associate/Bachelor degree in Psychology, Behavioral Science or in health science related field.
- Familiarity with and ability to use process improvement methodologies
COVID-19 CONSIDERATIONS:
All patients are subjected to COVID screening and are required to wear a mask when not receiving treatment. All staff members must be fully vaccinated.
Job Type: Full-time
Pay: $21.00 - $22.81 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid sick time
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
Work setting:
Education:
Experience:
- Healthcare or medical setting: 1 year (Required)
- EHR systems: 1 year (Required)
- Customer service: 1 year (Required)
License/Certification:
- CPR Certification (Required)
Work Location: In person