Clinical Care Coordinator

Holston Medical Group Career•Kingsport, TN

12h

About The Position

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. 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).

Requirements

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
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

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.