Care Coordinator (ECM) - Full Time Days

MLK Community Healthcare•Los Angeles, CA

About The Position

The Care Coordinator – Enhanced Care Management (ECM) functions as a liaison between patients, providers, and the healthcare system. The role ensures that patient needs, discharge planning, and care coordination are handled consistently with care management criteria. The Care Coordinator implements evidence-based services while adhering to patient necessity, levels of care, medical conditions, discharge plans, and medication plans. Duties may also include patient instruction, care orientation, navigation, and coaching.

Requirements

High school diploma or equivalent GED.
Valid unrestricted California Driver’s License and proof of vehicle insurance; both must be presented within 30 days of hire or transfer.
Ability to work as a team player, follow systems and protocols, and contribute to a common goal.
Must complete the annual Workplace Violence Prevention Program/Certificate during initial training or orientation, no later than 30 days from hire or transfer.
Highly organized, with well-developed oral and written communication skills.
Confidence communicating and conducting outreach with community healthcare organizations and personnel.
Sound judgment, decision-making, and problem-solving skills.
Proficient to expert computer skills, including Microsoft Office, especially Word and Excel.
Critical thinking, resourcefulness, and leadership skills.

Nice To Haves

Bachelor’s degree.
One year of customer service experience in a healthcare setting or similar environment.
Prior Cerner or Electronic Medical Record experience.
Prior employment in a healthcare facility and/or Street Medicine.
Bilingual Spanish.

Responsibilities

Participate in implementing the Enhanced Care Management program to help ensure eligible Medi-Cal beneficiaries receive enhanced care management and coordination.
Support patient self-management of disease processes and promote behavioral modifications and self-intervention.
Conduct home and street visits with ECM-eligible Medi-Cal beneficiaries for enrollment and ongoing services.
Advocate for patients and help them navigate the healthcare system.
Help patients navigate and access community-based services and support for healthy living.
Coordinate continuity of care with external healthcare organizations and facilities.
Coordinate continuity of care with patients and families or caregivers after hospital admission, discharge, and Emergency Department visits.
Report care barriers and challenges to a physician or designee.
Conduct comprehensive preventive screenings for patients and/or assist support staff with daily patient interactions as needed.
Promote clear communication among interdisciplinary care team members and ensure awareness of patient care plans.
Facilitate patient medication management according to standing orders and protocols.
Support data collection, health outcomes reporting, clinical audits, and pragmatic evaluation as a team associate.
Participate in evaluating clinical care and resource utilization, and in developing clinical tools, forms, and procedures.
Collaborate with leadership to coordinate project plans and timelines, support project team members, track deliverables using appropriate tools, and identify project risks and recommend resolutions.
Work on projects involving metrics, physician dashboards, and quality metrics.
Assist with creating and submitting Medical Group invoices.
Travel to MLKCH ambulatory, hospital, and administrative sites as needed to support patient care.
Perform other duties as assigned.