Care Continuum Partner

Lehigh Valley Health Network•Allentown, PA

1d•Onsite

About The Position

The Care Continuum Partner serves as the main liaison between patients, families, and the clinical team throughout the continuum of care. The role partners with patients and families to coordinate, navigate, and schedule care across outpatient services, procedures, community resources, and transitions of care. It meets patients within physical and virtual settings and supports advanced patient partnerships, including appointment scheduling and addressing care needs and compliance opportunities both inside and outside the organization. Working with the clinical care team, the Care Continuum Partner supports pre-visit planning, referral management, intake, scheduling, pre-certification, follow-up calls, and record retrieval. The position coordinates complex appointments involving multiple resources and services; assesses patient and family needs; supports care-plan compliance; and facilitates communication among providers, clinical teams, and related services. It provides clear preparation instructions for tests and procedures, connects patients and families with appropriate organizational and community resources, maintains patient records and authorization/referral requirements, and assists patients with patient portal and medical-record technology as a Virtual Care Concierge partner.

Requirements

High school diploma or GED and commitment to advance education.
Two years of experience interacting with patients, including performing at least some of the listed core functions.
Three years of experience working within a complex health system environment or related field.
High degree of accuracy and attention to detail.
Enhance skills through continuing education.
Ability to handle numerous tasks at the same time.
Superior customer service skills.
Working knowledge of basic computer functionality.
Effective and professional written and verbal communication.
Ability to handle patients and families in stressful situations.
Ability to maintain strict confidentiality.
Ability to adapt to changing priorities.
Critical-thinking skills and a solutions-focused approach.

Nice To Haves

Technical school diploma, specialized diploma, or associate's degree.
Knowledge of and experience with electronic medical records and scheduling software.
Knowledge of medical terminology.

Responsibilities

Participate in and support pre-visit planning with the clinical care team to promote smooth practice operations and patient flow.
Support referral management and intake, scheduling, pre-certification, follow-up calls, and record retrieval.
Coordinate and schedule complex appointments across the continuum of care, including procedures, surgery, office visits, diagnostic imaging and testing, labs, new-patient coordination, and therapeutic care plans.
Assess patient and family needs and support care-plan compliance through intake, coordination, and outreach about care and appointment needs.
Communicate with patients through telephone, patient portals, and other applicable virtual platforms.
Facilitate communication among physicians and providers, clinical teams, and financial, outpatient, ancillary, and supportive services.
Explain how to prepare for tests and procedures and what to expect upon arrival; provide patients with a care-continuum plan and explanation of necessary care elements.
Create a warm and welcoming environment for patients, families, and staff through customer service and compassionate care.
Connect patients and families with internal and community resources, including financial counseling, transportation support, social work, counseling, nurse navigation, nutrition services, and support groups, based on social determinants of health.
Support the care team's assessment of social determinants of health and other community and psychosocial needs.
Create and maintain patient records and manage visit prior-authorization and referral requirements.
Serve as a patient and family resource for patient portal and medical-record technology, and provide Virtual Care Concierge assistance when appropriate.