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Care Coordinator
This position is: Full Time
Position Location: Clinical

POSITION PURPOSE

The Care Coordinator is responsible for ensuring patientsí experiences with the LSU Healthcare Network are seamless and comprehensive. The Care Coordinator will review, plan and coordinate health care services in order to utilize appropriate processes and appropriate resources to improve membersí health outcomes. The Care Coordinator will use clinical and organizational knowledge to perform on-going assessment, identify gaps in care, recognize problem identification, recognize referral opportunities, and provide education and follow-up in order to coordinate care and improve patient outcomes.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Promotes a professional, positive image
  • Understands the various health plans and quality metrics
  • Engages patients in the management of their health and well-being to make optimal use of their encounters
  • Identifies caps in care and identifies an action plan(s) to close the gaps appropriately and timely
  • Facilitates appointments with the PCP and specialists
  • Conducts pre-visit planning by reviewing data prior to the scheduled appointment with PCP. Identifies HEDIS/STAR measures needed, current/past medication record, and current services being provided; creating a fact pack for the provider
  • Ensures proper CPT II/non-billable coding in the eHR in order to maximize and capture HEDIS and quality metrics
  • Identifies additional services needed and coordinates those services for the patient to ensure whole-person orientation
  • Works with providers and team members to coordinate patient care and provides appropriate documentation needed to the provider and/or team to ensure continuity of care
  • Enhances organization reputation by accepting ownership for accomplishing new and different requests; explores opportunities to add value to job accomplishments
  • Demonstrates passion for excellence with respect to treating and caring for patients
  • Documents and utilizes appropriate referrals to coordinate needed resources for patients and submits appropriate documentation to support referral
  • Assists patients with scheduling appointments for testing, treatments, follow-up, office procedures, etc. and assists in obtaining authorization and/or providing appropriate documentation for referral/appointment
  • Ensures results of testing, treatments, office procedures, etc. are received, reviewed and documented in member record accurately and in a timely manner. Communicates results appropriately with the proper channel
  • Identifies, documents, and communicates concerns or problems affecting patients to the appropriate departments. Actively follows-up on concerns or problems until resolved, and communicates resolution to patient and physician(s)
  • Reviews and ensures documentation of member encounter is appropriate to satisfy HEDIS/STAR measures
  • Coordinates with team members post hospital discharge visits, performs medication reconciliation and alerts provider to any issues or discrepancies with medications
  • Documents in the EHR any pertinent information discussed or completed with members to ensure communication across departments
  • Reviews HEDIS/STAR/RISK reports and Care Gaps at least monthly with the Director of Quality in order to coordinate an action plan for improved measure performance and patient outcomes
  • Performs other job related duties as requested


Requirements:


EDUCATION

  • Licensed Practical Nurse, or Medical Assistant certification preferred
  • Minimum 2 years clinical experience in a patient care environment in clinical or similar setting required
  • Experience in managed care industry preferred
  • Knowledgeable and experienced in computer skills particularly Microsoft Office products and Electronic Health Record

KNOWLEDGE, SKILLS AND ABILITIES

  • Professionalism
  • Strong verbal and written communication skills
  • Planning and organizational skills
  • Creative/innovative thinking
  • Highly developed sense of integrity and commitment to customer satisfaction
  • Conflict management and resolution
  • Manages time appropriately/efficiently/effectively
  • Strategic thinker
  • Problem solving and decision making
  • Effective listener
  • Excellence with interpersonal relations
  • Ability to work independently and proactively, and make decisions
  • Ability to handle multiple demands of diverse workload and prioritizes critical issues
  • Ability to effectively interact with multifaceted medical professional staff
  • Ability to communicate clearly and professionally, both verbally and in writing
  • Has a pleasant, patient and friendly attitude
  • Strong detail orientation and communication/listening skills
  • Possess a strong work ethic and team player mentality
PHYSICAL DEMANDS
  • Must be able to lift 10-15 pounds and operate standard office equipment, computer, printer, fax and copier
  • Ability to travel between various PCP offices and hospitals
  • Must be available to work extended hours, overtime and non-traditional hours as needed

Posted: 04/12/2017

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