Patient Care Coordinator (Social Worker)

Job Description

Job Description

Position Summary :

The Patient Care Coordinator will perform and provide oversight to all aspects of care integration services, including, but not limited to care coordination activities, chronic care management activities, specialty referrals / follow-up services, and virtual care; This position also functions as a patient advocate and navigator when communicating information to and from the patient care team.

Principal Duties and Responsibilities :

1. Provides oversight to care integration services and programs, including collaborating with assigned staff and / or performing duties / assignments associated with care coordination, chronic care management, specialty referrals and follow-up services, and virtual care

2. Assists patients through the health care system by acting as a patient advocate and navigator for in-person and / or virtual communications and visits

3. Develops and establishes working relationships with multiple departments to ensure cohesive communication and direction

4. Provides and / or coordinates Medicaid care coordination services to establish recipients as patients in their medical home and to promote understanding of benefits and services available to them

5. Provides and / or coordinates Medicare care coordination services to educate recipients on available benefits to them and coordinate wellness / preventative visits as well as follow-up services (as needed)

6. Participates in screening patients for social determinants of health and directing them to resources and / or referrals to applicable services (as needed)

7. Ensures continuity of care by making follow-up contacts with patients per provider directives and based on established guidelines

8. Provides and / or coordinates follow-up to referrals from the primary care provider to specialty providers, ensuring patient health information is exchanged and documented appropriately

9. Participates in PCMH team meetings / huddles and quality improvement activities and initiatives

10. Participates (as assigned) in data collection, patient outcomes and quality performance reporting, UDS reporting, and programmatic evaluations

11. Maintains confidentiality of patients and corporate information.

Qualifications :

1. LBSW, LGSW, LPN, or RN required

2. At least 2 years of experience in a health care setting is preferred.

3. Appropriate licensure in specific discipline is required.

4. Must have basic computer skills.

Company Description

What is Quality of Life Health Services?

• A private, non-profit corporation committed to community service.
• A medical home for you and your family.
• A health care provider with 24 locations serving 18 counties in Alabama.
• An organization with more than 47 years experience in health care.
• A primary care provider offering a broad base of ancillary services.
• A caring company serving to offer excellent customer service.

Company Description

What is Quality of Life Health Services?\r\n- A private, non-profit corporation committed to community service.\r\n- A medical home for you and your family.\r\n- A health care provider with 24 locations serving 18 counties in Alabama.\r\n- An organization with more than 47 years experience in health care.\r\n- A primary care provider offering a broad base of ancillary services.\r\n- A caring company serving to offer excellent customer service.