Description

SUMMARY:

The Emergency Department and In-Patient Follow-Up Care Manager plays a crucial role in ensuring continuity of care for patients who have been treated in the emergency department (ED) and subsequently admitted to the inpatient (IP) unit. The primary responsibility of this role is to facilitate efficient and effective communication between the ED and IP teams, ensuring seamless transitions and proper follow-up care for Family Health Services’ patients.

LPN/SW: Starting pay of $20.50 DOE

RN: Starting pay of $27.00 DOE

MINIMUM QUALIFICATIONS:

RN or LPN licensure. Prefer 2 years of experience in the fields of health or public health. Emphasizing community and population health and care coordination is desirable. Fluency in written and spoken English, Spanish bilingual preferred.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Excellent organizational skills and strong written and verbal communication skills.
• Strong computer skills, particularly in Microsoft Office. EHR experience preferred.
• Ability to build and maintain effective partnerships internally and externally with an awareness of community resources.
• Ability to work with patient and client groups and experience in membership organizations.
• Ability to work with minimal supervision and maximum accountability to problem-solve and work independently and collaboratively as a member of a team.
• A professional demeanor, with pleasant manner in telephone and personal contacts.
• Analytical skills with the ability to manage and prioritize multiple tasks.
• Commitment to patient-centered care and cultural sensitivity.
• Ability to collaborate with other healthcare professionals within Family Health Services and outside specialists to coordinate patient care and ensure continuity of services.

DESCRIPTION OF DUTIES:

1. Follow up with patient upon discharge from the emergency department or inpatient discharge.
2. Assess patients' health concerns and provide appropriate advice or direct them to the appropriate resources.
3. Determine if patients require immediate attention or if their concerns can be addressed through scheduled appointments or follow-up calls. Coordinate with patient’s clinic or call center to be scheduled.
4. Prioritize patients based on the severity of their condition and medical needs.
5. Refer patients to appropriate healthcare providers, or services within Family Health Services, depending on their presenting symptoms or medical conditions.
6. Offer basic health education to patients, including preventive care, medication instructions, and lifestyle recommendations.
7. Provide information on community health programs and resources available to patients.
8. Identify and respond promptly to medical emergencies within Family Health Services, and initiate appropriate emergency protocols and notify the healthcare team.
9. Assist in quality improvement initiatives to enhance the efficiency and effectiveness of the triage process.
10. Coordinate and work with Care Managers to help support patient panels as needed, including triage and healthcare outcomes.
11. Participate in meetings and committees as assigned.
12. Perform other duties as assigned.

OTHER RESPONSIBILITIES:

SAFETY:

Family Health Services enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions, and providing feedback to supervisors and management on all safety issues.

COMPLIANCE (MEDICARE):

Family Health Services is committed to the very highest standards of ethics and integrity. It is our policy to properly determine the accuracy of reporting and billing our services in accordance with the rules, laws and regulations of FHS, the state government, and the federal government. FHS employees will do their part to ensure accurate documenting and billing practices, participate in compliance trainings and will identify and report any concerns or activities that may violate these standards.

Each employee will be trained on the FHS Medicare Compliance Plan and the Standards of Conduct and asked to sign a Conflict of Interest Statement at hire and annually thereafter. A copy of the Medicare Compliance Plan and the FHS Standards of Conduct are available on the FHS home page under the Compliance tab.

PATIENT CENTERED MEDICAL HOME (PCMH):

Family Health Services is committed to providing our patients with the highest standards of care by becoming recognized as patient centered medical home. FHS staff is expected to participate in this process by being an active and willing PCMH team member. Specific duties and expectations may vary and will be identified by position and site.

PROCEDURE COMPLIANCE:

Employee must read and understand the general and specific operational, safety, and environmental requirements of all plans, procedures, and policies pertaining to this job.

WORKING CONDITIONS:

Work is normally performed in a typical interior/office work environment. No or very limited physical effort required. No or very limited exposure to physical risk.