Care Coordinator

SUMMARY

Montage Medical Group’s Collaborative Care Services (CCS) department supports patients and care teams in navigating the complex healthcare system with compassion, kindness, and reliability. We are trusted in our knowledge and follow through. We meet our patients where they are and advocate for their needs. Our team consists of Registered Nurse Care Managers, Licensed Vocational Nurse (LVN) Clinical Care Coordinators, Social Workers, Pharmacy Technicians and Care Coordinators. The Care Coordinator is responsible for supporting defined patient populations in reaching optimal health. This includes but is not limited to proactively outreaching to patients to coordinate preventive care and disease management (i.e. diabetes and hypertension). Additionally, the Care Coordinator promotes “working at the top of license” by supporting our licensed team members (RN’s, LVN’s, and LCSW’s) in completing tasks that do not require a license to complete. Our Care Coordinators are the glue that brings all elements of a patient’s care together.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Key Responsibilities Include:

• Telephonically contacts patients who are due for preventive screenings.
• Telephonically contacts patients to coordinate chronic disease follow up and testing.
• Schedules appointments.
• Follows standardized protocols to place orders for due or overdue testing.
• Provides follow up contact with patients as indicated to ensure adherence to provider recommendations and treatment plans (i.e. medications, imaging, lab testing, specialist visits).
• Connects patients to community resources to address social determinants of health.
• Collaborates with internal and external care team members in coordinating patient care throughout the healthcare continuum.
• Adheres to administrative and assigned practice standards regarding confidentiality.
• Attends and participates in team meetings.
• Adheres to the attendance and punctuality policy.

SUPERVISORY RESPONSIBILITIES

This position has no supervisory responsibilities.

MONTAGE VALUES

Employees of Montage Medical Group are expected to uphold the Montage Values and Service Standards. Montage Medical Group employees find joy in caring for those we service, are dedicated to coordinating care across all settings, take ownership, collaborate to deliver the highest quality care and are entrusted to serve our community with respect.

EDUCATION:

• Required: High school diploma or general education degree (“GED”) & Completion of a Community Health Worker (CHW) training program accredited by a recognized institution, or commitment to complete such a program within 18 months of hire.
• Preferred: Certificate or associate's degree in medical assisting

EXPERIENCE:

· Required: 2 or more years of experience working in a primary care setting

SKILLS AND ABILITIES:

• Ability to appropriately interact with patients, families, staff and others.
• Strong interpersonal skills to handle sensitive situations and confidential information.
• Must respond sympathetically and maturely to patient needs.
• Detail oriented and well organized.
• Skill in health information management by appropriately charting patient data.
• Strong computer skills with strong capabilities in MS Office Suite i.e. Outlook, Word, Power Point and Excel
• Ability to function effectively in a fluid, dynamic, and rapidly changing environment.
• Ability to articulate clearly and concisely both verbally and in writing.
• Ability to self-direct in keeping with departmental and organizational priorities.
• Ability to work autonomously and be directly accountable for assignments.
• Ability to work effectively as a team member with physicians and other staff.
• Ability to apply attention to detail and accuracy.
• Bilingual English/Spanish is preferred.
• Knowledge of Monterey County community resources is preferred.

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 accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stand; walk; climb or balance; and stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, and ability to adjust focus.