ASSISTANT CLINICAL CARE COORDINATOR (PRIMARY CARE CLINIC)

Fort Defiance Indian Hospital Board, Inc.•Fort Defiance Agency, AZ

20h•$29 - $36•Onsite

About The Position

This role is responsible for coordinating patient care within a primary care clinic, focusing on developing and implementing comprehensive care plans, coordinating with various internal and external services, and serving as a resource for patients, families, and staff. The position involves educating, counseling, and supporting patients and their families, as well as assisting with the identification and management of chronic care needs. The Assistant Clinical Care Coordinator will also contribute to quality improvement initiatives and maintain professional growth.

Requirements

Two (2) years of Nursing Assistant, Medical Assistant, or Health Care related experience in a clinical, medical/surgical, critical care, or outpatient setting.
Associate of Science degree in Nursing, Social Work, Human Services or related field from an accredited program.
Valid American Heart Association (AHA) certification in Basic Life Support (BLS) and maintain certification.
Valid and unrestricted license in any U.S. State or Territory.
Valid, unrestricted insurable driver’s license.
Resume and references are required.

Nice To Haves

Enrolled member of the Navajo Nation (primary preference).
Member of other federally-recognized Indian tribes (secondary preference).

Responsibilities

Develops and implements comprehensive care plans with patient, family, and team, evaluating and updating them based on patient/family needs.
Coordinates inter-organizationally with family, clinics, inpatient services, mental health, and other involved services and agencies.
Facilitates meetings or team conferences and attends community meetings with family as necessary.
Cultivates and supports assigned care and subspecialty co-management with timely communication and integration of information into the care plan.
Educates, counsels, supports, and provides patient-appropriate anticipatory guidance, intervening or facilitating referrals in crisis situations.
Builds care relationships and patient-specific skills among family and team, supporting the primary care-giving role of the family.
Facilitates patient/family access to available medical, psychological, developmental, educational, social, and financial services and support.
Assists with or promotes the identification of patients with chronic care needs, adding to and maintaining the chronic disease registry.
Understands eligibility requirements, referral processes, and funding details for public and private sector services and programs, and formulates procedures to facilitate access.
Serves as the point-of-contact, advocate, and informational resource for family and community partners/payers, including a close working relationship with the FDIHB Purchase Referred Care department.
Serves as a consultant and resource person to FDIHB staff on issues regarding patients and their care.
Assists with the development and maintenance of policies and procedures related to the care and coordination of complex patients with chronic diseases.
Assists with the development and maintenance of policies and procedures related to the screening of patients for complex, chronic medical issues.
Assists with the development of formal referral forms, policies, and procedures for accessing services.
Serves as a quality improvement team member, helping to measure quality and implement practice improvements.
Maintains professional growth and development through seminars, workshops, independent study, and professional affiliations.
Attends to specific clinical needs of empaneled complex patients in the clinic and/or on the inpatient unit, collaborating with primary care providers and clinical nurses.
Offers outreach and education to the community related to chronic care patients, their issues, needs, and the function of the Chronic Care Model.
Assists with the development and maintenance of related educational materials and provides instruction to meet the needs of the target audience.
Utilizes theories and principles of education/learning to foster the educational development of the target audience.
Fields queries from the community regarding patients with chronic care diseases.
Completes all yearly Center for Medicare and Medicaid Services (CMS) required training by the indicated due dates.
Assists, promotes, and supports compliance with established CMS standards.
Performs other duties as assigned.