Care Coordinator (Bilingual Spanish)

Description

At Claremedica, exceptional is the standard.

Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the Claremedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives.

That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At Claremedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.

Opportunity awaits – welcome to Claremedica.

ESSENTIAL FUNCTIONS

A Care Coordinator coordinates patient care from admission to discharge, ensuring efficient utilization of resources and delivering high-quality healthcare services. Collaborate with providers and stakeholders to optimize care experience and outcomes.

DUTIES AND RESPONSIBILITIES

• Act as the primary point of contact for high utilization patients, addressing their medical concerns and questions.
• Communicate with hospitals, attending physicians, PCPs, and Insurance Carriers' Nurse Reviewers to track daily admissions and discharges.
• Coordinate medical care follow-up for patients discharged from inpatient facilities.
• Assist PCPs in placing patients in skilled nursing facilities.
• Coordinate all aspects of patient care, including appointments, tests, treatments, and follow-up care.
• Facilitate referrals to specialists or other healthcare facilities as needed for continuity of care.
• Advocate for the patient's needs and preferences to ensure a smooth medical journey.
• Identify and access community resources, social services, and support programs to assist high utilizer patients.
• Educate patients about available resources and provide guidance on accessing them.
• Regularly analyze utilization data and patient outcomes to identify trends and areas for improvement.
• Maintain accurate and up-to-date patient records and documentation of all interactions and interventions.

SUPERVISORY RESPONSIBILITIES

• This position does not have supervisory responsibilities.

• WORKING CONDITIONS

  General office working conditions.

   

  PHYSICAL DEMANDS

  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function. 

   

  While performing the duties of this job, the employee will be required to stand, walk, sit, use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust your focus.  Manual dexterity is required to use desktop computers and peripherals. 

   

  WORK ENVIRONMENT

  The work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. 

   

  The noise level in the work environment is usually moderate.

   

  TRAVEL

  Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.

   

   

   

  SAFETY HAZARD OF THE JOB

  Minimal Hazards

Qualifications

QUALIFICATIONS/REQUIREMENTS

• Utilization management and/or transition of care and/or quality improvement experience preferred.[AL1] 
• Knowledge of computer programs.
• Familiarity with Availity system.
• Ability to operate a computer and basic office equipment.
• Knowledge of ICD coding and HEDIS measures.
• Knowledge of HMO and medical terminology.
• Maintain effective working relationships.
• Strong organization, oral/written communication skills.
• Own transportation between facilities required.