Care Coordinator II - DME Coordinator

Working Conditions Work Environment: Indoor/Office Member/Patient Facing: Telephonic Hazards: May include physical and ergonomic hazards. Equipment: General office equipment. Travel: May include occasional required or optional travel outside the workplace. Work Location: Hybrid – Office 1-2 days/month. Estimated Hiring Range $28.81 - $35.22 per hour Bonus Target 5% Annual Essential Responsibilities Patient Communication Actively support an assigned panel of patients by providing timely complex care coordination for patients with physical and behavioral health care needs. Escalate concerns to the primary care team according to protocols. De‑scale high‑stress situations and complaints, forwarding them to the primary care team or leadership as appropriate. Coordinate referrals for supportive services, labs, diagnostics or other coordination of care needs as requested by the primary care team based on insurance, location, patient preference, and order type. Schedule patient visits based on urgency, geographic location, appointment type, provider availability and frequency of visit standards. Clinical Support Authorize prescription refills for non‑controlled drugs if approved by clinician. Provide pharmacy support including verbal orders, when appropriate, to expedite or clarify medication fulfillment. Provide primary care coordination support to assigned panel of patients with physical and behavioral health care coordination needs. Meet with DME vendors to maintain relationships and solve problems. Manage DME orders, ensuring charting and all documentation requirements are met. Support providers and patients with the DME appeal process and follow up to ensure delivery. Coordinate complex care with support services and community partners, including but not limited to home health and hospices, according to the patient’s plan of care. Create or update patient charts and enter insurance, demographic, medication, diagnosis and social information in the EHR to ensure accuracy and compliance with policies and procedures. Co‑coordinate care for patients with chronic and serious illness with internal and external stakeholders. Coordinate with the care team to ensure unique needs are considered in integrated planning and that physical and behavioral health plans are timely and effective. Develop partnerships with patients, families, caregivers and community care providers, payors regarding patient needs and care plans. Assist with transitions in care from multiple settings to ensure continuity of care and address urgent issues appropriately, working with the care team to schedule transition visits according to protocols. Update hospice and home health regarding patient hospitalizations and transitional care visits. Act as a consult to other teams and roles (external and internal) for geographically specific resources. Help patients, caregivers and families establish or engage with providers by coordinating appointments and transportation as needed. Arrange family and/or caregiver attendance at appointments, and interpreters as required. Provide information about appointments, care plans, medications, referrals, prior authorizations and DME requests. Identify risk factors and service needs that may impact patient outcomes and address them appropriately. Use a trauma‑informed, person‑centered approach to provide patient‑centric physical and behavioral health care and support, including communication, education, and care planning. Assist patients with moving through the continuum of care based on clinical/medical/behavioral health needs by collaborating with the PCP, Primary Care Clinical Team (PCT), palliative care and hospice teams. Use motivational interviewing to coach patients toward improved physical and behavioral health behaviors and self‑management. Coordinate clinicians’ diagnostic and lab orders, including lab and diagnostic testing, medical supplies and equipment. Provide timely outreach, education, and follow‑up on labs or diagnostics or clinical instructions from a member of the primary care team. Implement the physical and behavioral health care coordination plan in collaboration with the patient’s care team, including patient, family, caregiver, internal team members, external providers, case workers and other relevant parties. Documentation and Other Duties Compile and document all patient interactions and support activities in an appropriate and timely fashion to maintain the patient’s medical record. Participate in quality and organizational process improvement activities and teams when requested. Take initiative in proactively assisting teammates when work volumes are high or back‑up is needed. Experience and/or Education Minimum 4 years’ experience in a healthcare setting, including experience with a medical records system. Knowledge Advanced knowledge of basic healthcare language, including medical and/or behavioral health terminology, basic patient care and community resources. Demonstrate advanced knowledge of barriers to care such as language, cultural factors, transportation, self‑management ability and psychosocial issues, bringing those to the attention of the care team. Knowledge of HIPAA privacy rules and regulations. Advanced knowledge of basic conflict management and de‑escalation techniques. Skills and Abilities Leadership skills, including the ability to organize work and train/mentor others. Participate in work‑related continuing education when offered or directed. Excellent customer service skills, interacting professionally, patiently and courteously with staff, patients, families and vendors over the phone and in‑person. Employ motivational interviewing, healthcare teaching and coaching skills, or the ability to learn them. Advanced organizational skills, with the ability to manage multiple tasks and timelines in a high‑stress environment, including: Prioritizing tasks, managing telephone calls with a professional demeanor, problem‑solving and staying focused. Working independently and collaboratively. Using good judgment, personal initiative and discretion to perform job responsibilities. Taking initiative and utilizing innovative techniques and ingenuity. Advanced ability to establish and maintain effective communication and collaborative relationships with colleagues, departments throughout the organization and external providers and community agencies. Advanced computer application skills, including MS Windows, Word, Excel and Outlook. Detailed understanding of electronic medical record systems and the ability to integrate updates to those workflows on a regular basis. Advanced ability to facilitate group discussion or case review. Learn, focus, understand, evaluate information and determine appropriate actions. Employ critical thinking and draw conclusions from conversations and written or computer‑generated material. Ability to communicate effectively with diverse staff, patients, families, and caregivers. Ability to work effectively with diverse individuals and groups. Ability to learn, focus, understand, and evaluate information and determine appropriate actions. Ability to accept direction and feedback, as well as tolerate and manage stress. Ability to perform repetitive finger and wrist movements for at least 6 hours a day. Ability to hear and speak clearly for at least 3-6 hours a day. Benefits Housecall Providers offers a combined benefits package that includes medical, dental, vision, life, AD&D, disability insurance, health savings account, flexible spending account, lifestyle spending account, employee assistance program, wellness program, discounts, and supplemental benefits such as voluntary life, critical illness, accident, hospital indemnity and identity theft protection. Employees are eligible for benefits beginning on the first of the month after their start date, and non‑benefits‑eligible employees may receive contributions to a 401(k) and other non‑salary benefits. Equal Employment Opportunity Housecall Providers is an equal‑opportunity employer. The organization selects the best individual for the job based upon job‑related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of its organization. #J-18808-Ljbffr Housecall Providers