Clinical Care Coordinator

Job Description

Job Description

If you are a motivated and reliable person with exceptional customer service skills and the ability to thrive in a fast-paced environment, come join Holston Medical Group.

We are looking for friendly, courteous employees to ensure a positive patient experience and welcome a teamwork environment.

WHAT WE OFFER :

• Company paid Life and Accidental Death and Dismemberment Insurance
• Company paid Long Term Disability Insurance
• 401(k) and Roth Retirement plan with Company Contributions
• Medical, Dental, Vision, and additional Life and STD Insurance
• Health Savings Account Plan with company contributions
• Paid time off
• Paid Sick time
• Paid Holidays
• Employee discounts
• And more!

General Summary :

The Clinical Care Coordinator will outreach to any patient with a recent hospital admission / discharge, addressing the patient needs and working with the patient to minimize risk of readmission.

They will work with the patient for education of a chronic disease state such as, but not limited to, hypertension, diabetes, COPD, CHF, and renal disease.

The Clinical Care Coordinator will also work to address patient needs when the Primary Care provider sends a Care Coordination referral on a patient.

They will act as a go between for the patient and primary care provider or specialty provider that is assigned to this patient’s care team and will schedule patient appointments as needed.

The Clinical Care Coordinator will track the patient engagement / enrollment in Care Coordination on tracking spreadsheet (s).

Main Responsibilities :

• Establish close relationships with patients that will increase compliance with treatment recommendations and patient management plans
• Maintain communication with providers and collaborate care with patient
• Maintain strict confidentiality in all matters relating to patient PHI (Patient Health Information)
• Review data within the patient chart which can be used to attest for a HEDIS measure and outreach to the patient for review / discussion of the specific gaps in care
• Coordinate and schedule appointment for patients to address specific gaps in care. Review payer scorecard and work with Operations Management Team to improve overall STAR rating for the group
• Coordinate and schedule appointments for patients to address specific patient need
• Ensure appropriate documentation or results are listed within the EHR, complete manual attestations within the payer’s system for HEDIS gaps in care reporting
• Review payor scorecard for patient gaps in care.
• Work with Manager or Clinical Care Coordinator Team Lead on payer scorecards and ways to potentially increase overall STAR rating for organization
• Pull the eligible patient list, perform chart review to determine if a patient may qualify for the Eastman Hypertension or Diabetes Program based on program criteria, and work with the Program Director for potential enrollment in the program.
• Keep track of the patients enrolled in the program utilizing a patient list
• Responsible for generating and sending monthly and biannual invoices to Eastman for the patients who are enrolled in the program.
• Responsible for scheduling patient follow up visits and helping to educate the patient on the disease states of hypertension and diabetes.
• Work with resources onsite at Eastman for continuation of patient education / disease management and will make appropriate referrals to Cigna Case Management as needed;

and will provide Manager or Clinical Care Coordinator Team Lead a weekly list of patients who are outreached for reporting to Cigna Eastman insurance.

Education / Experience / Knowledge :

• Minimum high school diploma or equivalent required
• LPN licensed by the state in which employed or Registered / Certified Medical Assistant
• Ability to work independently with strict adherence to protocols in an accountable manner
• Empathetic and patience to patient / patient family
• Excellent communication skills both written and oral
• Superb time management, organizational, critical thinking, and problem-solving skills
Key Competencies :
• Compassion
• Compassion
• Customer focus
• Ethics and values
• Interpersonal savvy
• Problem solving
• Critical thinking skills
• Empathy
• EHR and scheduling proficiency
• Basic knowledge of Microsoft Office
• Knowledge of HEDIS Gap Measures

We are an Equal Opportunity Employer. We do not discriminate on the basis of race, religion, color, sex, age, national origin or disability."