Medical Assistant Population Health - DeKalb Primary Care Rainsville - FT - 1st Shift

Overview

Centered in a clinician provider practice, this individual works in partnership with patients, families, nurses, physicians, other qualified healthcare providers and clinical disciplines. Coordinates care for patients with chronic disease and manages effective care transitions for them within the continuum. Partners with the provider care team for successful preventative care visits to reduce the severity of chronic disease and avoidable acute illness. Provides effective clinical health coaching to assist patients with self-management of their chronic disease and life-style changes to mitigate health risk. Promotes effective partnerships and utilization of community resources. Facilitates a “shared goal model” within and across settings to achieve coordinated high-quality care that is patient and family-centered.

Responsibilities

• Serves as the contact-point, advocate, and informational resource for the patient, family, careteam, & payers• Provides a coordinated, strategic approach to detect early and manage effectively the chronicallyill patient population and reduce readmissions• Promotes healthy behaviors in all populations and ensure navigation assistance with communityresources.

• Facilitates patient access to appropriate medical resource and preventative services• Demonstrates evidence of essential leadership, communication, education, collaboration, andcounseling skills.• Effective organizational skills and demonstrates ability to maintain accurate notes and records.• Proactively acts as a patient advocate, responding with empathy and respect to resolvepatient/family concerns.

Qualifications

Education Required: High School Diploma or GED equivalent.

License, Certification and/or Registration: Medical Assistant certification required.

Experience: Previous 3 years medical experience, preferably in an office/clinic setting caring for chronic disease patients.