Care Management Coordinator (Duchess and Ulster counties)
Northwell
Job Description Coordinates and participates in activities related to Care Management services to family members and caregivers. Job Responsibility * Utilizes patient-centered motivational interviewing techniques to build rapport and help patients improve their health. * Supports the primary care team by providing panel management to decrease the number of patients lost to care, non-compliant in follow up care or disconnected from primary care. Participates in the development, maintenance, and adjustment of individualized care plans for high-risk patients that address both medical and social barriers to accessing care. * Acts as a professional liaison between hospitals, primary care providers, specialists, and community resources on behalf of patients to ensure patient-centered care coordination. * Identifies and tracks special populations, including high-risk patients and other populations due for preventive or chronic care services. * Identifies and tracks patients discharged from the inpatient service or the emergency department. * Uses team-based communication strategies to close the loop on referrals, hospital follow-ups and any outstanding items identified in the patient's care plan. Performs outreach activities in primary care sites, homes, hospitals, and neighborhoods. Job Qualification
- High School Diploma or equivalent required.
- 1-3 years of relevant experience, required.
- Bachelor's or Master's degree in relevant field strongly preferred.
- Health home or care management experience strongly preferred.
- NYS Driver's License strongly preferred.
- Bilingual Spanish, preferred.
- Position is in the Duchess and Ulster counties
- Additional Salary Detail
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