Care Management Coordinator

About This Role

The Care Management Coordinator coordinates and participates in Care Management services for patients, family members, and caregivers. The role supports the primary care team by managing patient panels, developing individualized care plans, and acting as a liaison between healthcare providers and community resources.

Responsibilities

• Utilize patient-centered motivational interviewing techniques to build rapport and help patients improve their health
• Support 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
• Participate in the development, maintenance, and adjustment of individualized care plans for high-risk patients that address both medical and social barriers to accessing care
• Act as a professional liaison between hospitals, primary care providers, specialists, and community resources on behalf of patients to ensure patient-centered care coordination
• Identify and track special populations, including high-risk patients and other populations due for preventive or chronic care services
• Identify and track patients discharged from the inpatient service or the emergency department
• Use team-based communication strategies to close the loop on referrals, hospital follow-ups and any outstanding items identified in the patient's care plan
• Perform outreach activities in primary care sites, homes, hospitals, and neighborhoods

Requirements

• High School Diploma or equivalent
• 1-3 years of relevant experience

Qualifications

• High School Diploma or equivalent required. Bachelor's or Master's degree in relevant field strongly preferred.
• 1-3 years of relevant experience, required

Nice to Have

• Bachelor's or Master's degree in relevant field
• Health home or care management experience
• NYS Driver's License