Care Coordinator

Family HealthCare Network•Visalia, CA

5d•$22 - $30

About The Position

The Care Coordinator coordinates the provision of patient care within the Health Home Program (HHP) to ensure the patients’ care is continuous and integrated amongst service providers, as well as supports the Care Coordinator Manager in the implementation of the HHP. There will be responsibility for the navigation of the patient’s health, behavioral health, social systems, community resources, and housing transitions. There will be collaboration with patients and their family members, health-care team members, and outside organizations to reduce or eliminate barriers to care.

Requirements

Job duties require knowledge and training in the field of social work, nursing, health sciences, health education or a related field; or be a para professional with more than 7 years of directly related progressive work experience.
Ability to prepare more complex documents in Microsoft Word, including creating tables, charts, graphs and other elements.
Ability to use Microsoft Excel to review and compile data, including the use of formulas, functions, lookup tables and other standard spreadsheet elements.
Ability to create basic presentations in Microsoft PowerPoint.
Job duties require the compilation of information prepared in effective written form, including correspondence, reports, articles or other documentation.
Effectively conveys technical information to non-technical audiences.

Nice To Haves

A Bachelor’s degree with at least one year of experience, preferred.

Responsibilities

Support patient centered, continuous and consistent care, ensuring that an assigned Home Health Program (HHP) patient receives access to needed services identified through the assessment process.
Provide health promotion services similar to the role of a health educator, such as providing training materials and teaching self-management skills pertaining to the patient’s goals identified in the Health Action Plan (HAP) as part of the HHP.
Provide Individual, Family and Community Support Services
The Care Coordinator has a role as a housing navigator, such as assisting patients with housing transition services, individual housing and tenancy sustaining services.
Provide comprehensive transitional care
Responsible to support the Care Coordinator Supervisor in the implementation of Health Home Program initiatives, curriculum and objectives.
Care Coordinator interfaces with patients and other stakeholders through a variety of mechanisms, including, but not limited to: 1. Individual, face-to-face contacts through both appointment and warm hand-off contacts; 2. Telephone and other electronically mediated contacts; and 3. Contact outside of FHCN Health Centers to provide linkages to appropriate community resources based upon the patients’ identified needs and goals through the Health Action Plan. This could be a mobile unit for example.
During contacts with health-care team members at FHCN and from other organizations, Care Coordinators reduce barriers to care in a number of ways including but not limited to: 1. Preparing, printing and distributing the information necessary for care teams to engaging in Pre-visit Huddles. 2. Maintaining regular communication with care team providers on patient care plan goals and progress. 3. Facilitating regular communication between patient and other health-care team members both inside and outside FHCN. 4. Providing staff training and education sessions necessary to implement health education services. 5. Participates in meetings and trainings as necessary to facilitate the above duties, including those geared toward implementing evaluation tools that determine the effectiveness of Care Coordinator functions.
Responsible for adhering to the Attendance and Absenteeism Policy, recognizing that regular attendance is considered an essential function of all FHCN positions. Absenteeism is not being at work or failing to attend a paid workshop, training, or event unless the absence is protected by law.
Ability to present to and work at any FHCN location, both at the beginning of a shift or during a shift, based on business need.
Performs other duties as assigned.