Bilingual Patient Health Coach

Job Description

Job Description

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Training & development
• Vision insurance

Summary of Duties: Assists all patients through the healthcare system by acting as a patient advocate and navigator.
Participates in Patient-Centered Medical Home team meetings and quality improvement initiatives.
Facilitates health and disease patient education, including leading group office visits.
Supports patient self-management of disease and behavior modification interventions.
Coordinates continuity of patient care with external healthcare organizations and facilities, including the process of hospital admission and discharge and referrals from the primary care provider to a specialty care provider.
Coordinates continuity of patient care with patients and families following hospital admission, discharge, and ER visits.
Manages high-risk patient care, including management of patients with multiple co-morbidities or high risk for readmission to a hospital setting, including a registry.
Conducts comprehensive, preventive screenings for patients and/or assists all support staff in daily patient interactions as needed.
Promotes clear communication amongst a care team and treating clinicians by ensuring awareness regarding patient care plans.
Facilitates patient medication management based upon standing orders and protocols.
Participates on a team for data collection, health outcomes reporting, clinical audits, and programmatic evaluation related to the Patient-Centered Medical Home and Medical Neighborhood initiatives.
Evaluates the patients views on clinical care, utilization of resources, and assists in the development of new clinical tools, forms, and procedures.

Education and Experience: Essential:
Graduation from an accredited university with a background in science, including a BA or BS in Biology, Chemistry, Nursing, Anatomy and Physiology, Public Health, Behavioral Science, or a similar degree is preferred not required, however relevant skills in clinical settings working with diverse populations is required
Proficient computer skills, including Microsoft Office (specifically Word and Excel)
2-5 years experience in a clinical setting
Self-disciplined, energetic, passionate, innovative
A team player that can follow a system and protocol to achieve a common goal
Highly organized and well-developed oral and written communication skills
Demonstrates sound judgment, decision-making and problem-solving skills
Able to maintain confidentiality with all aspects of information in accordance with practice, State and Federal regulations
Confidence to communicate and outreach to other community health care organizations and personnel