Care Coordinator

Fortis Care•Atlanta, GA

5d•Onsite

About The Position

The Care Coordinator plays a key role in supporting patients with complex medical needs. Working under the supervision of the CCM Manager, you will work directly with patients, providers, and care teams to ensure coordinated, patient-centered care. This is an on-site, hourly role with a set Monday–Friday, 8:00 a.m.–5:00 p.m. schedule. It emphasizes patient engagement, care planning, and ongoing follow-up to prevent unnecessary hospitalizations and promote better health outcomes — delivered with the responsiveness and polish this building's patients and families expect.

Requirements

Licensed Practical Nurse (LPN) or Medical Assistant (MA) required.
Minimum 1–2 years of experience in care coordination, chronic care management, primary care, ambulatory care, skilled nursing, or hospital settings.
Knowledge of chronic conditions, evidence-based guidelines, prevention, and patient education.

Nice To Haves

Experience with care management documentation and EHR systems preferred.
Associate's degree or higher in a clinical or health-related field preferred.
Experience with quality improvement or care coordination a plus.
Prior experience in a service-forward, concierge, or hospitality-oriented setting a plus.

Responsibilities

Performs outbound calls to patients to understand their clinical needs and connect them with appropriate resources. Performs outbound calls to providers to make appointments for patients or follow up on care. Answers inbound calls from patients, providers, and other resources.
Serves as a warm, responsive point of contact for patients and families, setting clear expectations and closing the loop on every request.
Follows up with patients to ensure their needs are met and schedules future check-ins.
Monitors patient hospitalizations and follows up as necessary with care team members and outside resources to confirm Fortis Care gathers all relevant patient information.
Provides patients and family with education materials and sends communications to specialists for new enrollments/appointments.
Help identify and prioritize patients for medical services each day, including setting the schedule and prepping any charts to enable efficient and effective provider visits.
Coordinate care transitions, including timely post-hospital follow-up, medication reconciliation, and education on discharge instructions.
Partners closely with the on-site Advanced Practice Provider, facility nursing, therapy, and social work teams to keep care and communication seamless.
Document all care management activities accurately and in a timely manner.