What are the responsibilities and job description for the Care Coordinator-Referrals position at Primary Care & Hope Clinic?
Description
Reports To: COO
Employee Status: Non-Exempt (Regarding Overtime)
Position Summary: The Care Coordinator works in collaboration with Primary Care & Hope Clinic Medical and Behavioral providers and outside providers to assist patients and their families with coordination of their healthcare.
Essential Functions:
Care Coordination:
- Represent PC&HC to patients/visitors in a caring, courteous, and professional manner. Provide prompt, efficient and accurate patient service.
- Perform health insurance enrollment related duties including responding to requests for information; generating interest in enrollment through outreach, application assistance and follow-up; documentation of activities; access, utilization and retention duties; and related tasks.
- Assess the physical, functional, social, psychological, environmental, and financial needs of clients/patients; identify a cost-effective comprehensive plan to meet the families’ health care needs and implement the plan.
- Assess the client’s formal and informal support systems.
- Provide consultation to patient providing education on acute and chronic illness under the direction of a Medical Doctor or Nurse Practitioner.
- Provide consultation to patient for preventative health maintenance including annual examinations, diagnostic screenings, immunizations, nutrition, etc.
- Promote timely access to appropriate care
- Increase utilization of preventative care
- Reduce emergency room utilization and hospital readmissions
- Increase comprehension through culturally and linguistically appropriate education
- Create and promote adherence to a care plan, developed in coordination with the patient, primary care provider, and family/caregiver(s)
- Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals
- Increase patients’ ability for self-management and shared decision-making
- Provide medication reconciliation
- Connect patients to relevant community resources, with the goal of enhancing patient health and well-being, increasing patient satisfaction, and reducing health care costs
Referral Program:
- Make appropriate and timely referrals to specialist, DME or home health agency per request of provider.
- Contact the insurance carriers and initiate the referral process.
- Remain current on insurance pre-authorization requests.
- Respond promptly to calls from patients regarding the referral process.
- Compile all pertinent medical data and supporting documentation and fax or mail to appropriate receiver.
- Act as liaison between practice, patients, and referral sources complaints and problems.
- Plan and organize work load to maintain efficient patient operations in the health center.
- Prioritize patient referrals when needed.
Marginal Functions
- Improve the patient experience and health care processes and help assure the provision of high quality health care, as well as an ongoing process of performance improvement.
- Completes all required paperwork
- Perform all other duties as required or assigned.
Requirements
Requirements
- Bachelor’s degree in Social Work, Community and Public Health or Comparable degree preferred.
- Must maintain certification as a Certified Application Counselor for health insurance enrollment purposes.
- Must have knowledge of principles and methods for teaching and instruction for individuals and groups.
- Must communicate with patients in a friendly, positive manner.
- Must be able to operate office related equipment.
- Must follow HIPAA and OSHA requirements.