Ambulatory Care RN - Case Manager

Job Description

Job Description

Griffin Concierge Medical (GCM) is a membership-based primary care practice dedicated to personalized, prevention-focused healthcare. Our members value a collaborative, long-term relationship with their family physician based on trust and mutual respect. At GCM, culture is an important part of our collective success, and we live our core values every day: Relationships—Not Transactions, Strive for the Win-Win, Never Stop Improving, Done. These values guide us in our interactions with each other and with our members to deliver exceptional care.

Job Summary

At GCM, our Patient Care Coordinator (PCC) works closely with our members and physicians to provide high-touch, personalized care. Responsibilities include clinical and clerical work as necessary, communicating with patients via phone, email, text, triaging with patients to identify emergent and non-emergent situations, scheduling appointments, obtaining prior authorizations, and submitting prescriptions to pharmacies. The ideal candidate is a Registered Nurse with a minimum of 3 years of clinical and administrative healthcare experience. At GCM, Patient Care Coordinator team members who thrive enjoy detail-oriented administrative duties that require multitasking and timely completion of tasks.

General Accountabilities

Administrative

• Onboards new patients, which includes creating charts and profiles across various electronic platforms
• Ensures patient demographics are current and updates them, when necessary, across various platforms
• Schedules patients for encounters—in-office, telephonic, and virtual
• Schedules specialist appointments for patients. Ensures records are present for the visit and follows up to ensure we receive reports following the visit
• Answers telephone calls, emails, texts, and faxes and routes inquiries accordingly
• Communicates proactively with patients via email, text, and telephone
• Routes and requests medical records via e-fax
• Imports medical records to EMR
• Coordinates referrals to diagnostic centers
• Researches and informs patients of cash/self-pay costs associated with visits to outside facilities, including diagnostic centers and specialists
• Responds to patients’ insurance inquiries, including interpreting EOBs
• Reviews lab bills that require updated diagnosis codes and insurance information
• Ensures scheduling of annual exams, screening tests, and vaccines in a timely manner
• Facilitates third-party care coordination, including home health and hospitalizations
• Coordinates physician-to-physician consults
• Updates patient accounts for billing purposes
• Assists in the resolution of inquiries and requests to patient satisfaction
• Identifies potential gaps or breakdowns in communication and acts to prevent issues and errors

Clinical

• Acts as liaison between patient, family, and medical representatives
• Obtains health history information and documents current physical conditions.
• “Triages” patient calls to assess urgency and escalates to the physician when necessary
• Initiates and completes prescription prior authorizations
• Uses professional judgment with regard to patient education and prescription prior authorizations
• Practices most current safety and health code standards
• Enters chart data, including patient medical conditions, messages, and patient follow-ups in a timely manner
• Educates patients
• Records medications and supplements in patient charts
• Will cover holidays as needed

Qualifications

• Minimum Education: Associate Degree in Nursing (ADN) from an accredited nursing program
• Minimum Experience: 3 Years in Ambulatory Care Setting
• Minimum Field of Expertise: Administrative and clinical experience in a medical setting
• Minimum EHR experience: Three years

Competencies

• Knowledge of medical terminology
• Exemplary customer service skills
• Exemplary verbal skills
• Ability to maintain schedules
• Ability to maintain confidentiality
• Ability to respond to questions in a tactful and professional manner
• Ability/willingness to adhere to the established departmental service standards

Physical Demands

• Must be able to sit for the duration of the shift

Work Environment

• Office desk work

Benefits

• PTO
• 401(k)
• Medical, dental, vision, life, and short-term disability eligibility

Griffin Concierge Medical (GCM) is a membership-based primary care practice dedicated to personalized, prevention-focused healthcare. Our members value a collaborative, long-term relationship with their family physician based on trust and mutual respect.

Company Description

Griffin Concierge Medical (GCM) is a membership-based primary care practice dedicated to personalized, prevention-focused healthcare. Our members value a collaborative, long-term relationship with their family physician based on trust and mutual respect.