Care Management Coordinator - VIVOHealth

Northwell Health

22h

About The Position

The Care Management Coordinator coordinates and participates in activities related to Care Management services for family members and caregivers. The role supports primary care teams by helping patients improve their health, stay connected to care, and access coordinated, patient-centered services. The coordinator works with patients, caregivers, hospitals, primary care providers, specialists, and community resources, including through outreach in primary care sites, homes, hospitals, and neighborhoods.

Requirements

• High school diploma or equivalent required.
• 1–3 years of relevant experience required.

Responsibilities

• Use patient-centered motivational interviewing techniques to build rapport and help patients improve their health.
• Provide panel management to help the primary care team reduce the number of patients lost to care, non-compliant with follow-up care, or disconnected from primary care.
• Participate in developing, maintaining, and adjusting individualized care plans for high-risk patients that address medical and social barriers to accessing care.
• Act as a professional liaison among hospitals, primary care providers, specialists, and community resources to support patient-centered care coordination.
• Identify and track special populations, including high-risk patients and people due for preventive or chronic care services.
• Identify and track patients discharged from inpatient services or the emergency department.
• Use team-based communication strategies to close the loop on referrals, hospital follow-ups, and outstanding items identified in patients' care plans.
• Perform outreach in primary care sites, homes, hospitals, and neighborhoods.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED