WHO WE ARE: State of Franklin Healthcare Associates is a physician-led and employee-owned multi-specialty care group headquartered in Johnson City, TN, with locations in the upper East Tennessee & Southwest Virginia region. Our mission is to improve the health and well-being of our patients and our team members. PRIMARY RESPONSIBILITIES: Help patients transition from an inpatient setting back home or to a post-acute setting. Development, initiating, and monitoring of a plan of care for the patient self-management. Utilize knowledge of motivational interviewing techniques to enhance patient outcomes. Access, plan, implement, monitor, and evaluate options and services required to meet patients’ needs. Identify social determinants of health and refer patient of community resources and social worker support. Accurately document in the medical record and CareTrac. Assist providers with closing care gaps through patient outreach.
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Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed