Assist all patients through the health care system by acting as a patient advocate and navigator. Participates in Patient Centered Medical Home team meetings and quality improvement initiatives. Facilitates health and disease patient education, including leading group office visits. Supports patients’ self-management of disease and behavior modification interventions. Coordinates continuity of patients and families following hospital admission, discharge, and ED visits. Conducts comprehensive, preventive screening for patients and/or assists all support staff in daily patients interactions as needed. Promotes clear communication amongst a care team and treating clinicians by ensuring awareness regarding patient care plans. Facilitates patient medication management based upon standing orders and protocols. Participates on a team for data collection, health outcomes reporting, clinical audits, and programmatic evaluation related to the Patient Centered medical Home and Medical Neighborhood initiatives. Evaluates clinical care, utilization of resources, and development of new clinical tools, forms, and procedures. A team player that can a follow a system and protocol to achieve a common goal. Highly organized and well-developed oral and written communication skills. Demonstrates sound judgement, decision-making and problem solving skills. Able to obtain confidentiality with all aspects of information in accordance with practice, State and Federal regulations. Confidence to communicate and outreach to other community health care organizations and personnel. Self-disciplined, energetic, passionate, innovative. Performs all other duties as required. Assist all patients through the health care system by acting as a patient advocate and navigator.
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Education Level
High school or GED
Number of Employees
251-500 employees