Patient Care Coordinator

Harbor Community Clinic•Los Angeles, CA

About The Position

The Patient Care Coordinator will report directly to the Enabling Services Manager and will be responsible for providing community case management, including but not limited to providing linkages and resources to Harbor Community Health Centers patients. The Patient Care Coordinator will work in close collaboration with HarborCHC clinicians to assess patients’ needs, provide resources and support as appropriate, and to ultimately improve patient health outcomes and overall quality of life. The Patient Care Coordinator would need to perform all duties with independence, professionalism, precision, and confidentiality. This position is funded through the CITED grant and is currently approved through December 2026. Continued employment beyond the current grant period is contingent upon Harbor Community Health Centers securing continued funding.

Requirements

High School Diploma, or equivalent/AA degree; Bachelor’s degree in related field preferred.
Minimum 2 years of experience working in intensive case management/ or social services field, direct experience facilitating care coordination preferred.
Bilingual English/Spanish required.
Demonstrated commitment to working with families living in disadvantaged communities, of diverse racial and ethnic backgrounds is essential, along with a familiarity of the health disparities, challenges and areas of need among the community served by HarborCHC.
Strong verbal and written communication skills and the ability to convey information clearly.
Patient care-centered mentality.
Adept computer and internet skills required for routine data collection, data entry and reporting.
Experience with Microsoft Word and Excel Spreadsheets required; experience with electronic health records preferred.
Proactive, ability to identify and resolve problems in a timely manner; and to work well in a group and independently.
Excellent time management skills and ability to complete tasks on time; ability to multi-task.
Ability to adhere to HIPAA requirements, maintaining confidentiality and to use discretion and independent judgment.
Willingness and aptitude to work effectively and independently.
Committed to providing an exceptional experience in all interactions.
Must have strong analytical and problem-solving skills.
Must have proficient computer skills, including Microsoft Office abilities, with intermediate Excel skills.
Must have the willingness and ability to adapt to change, including advances in technology.
Ability to handle multiple tasks and be highly organized and detail-oriented.
Must maintain confidentiality and handle sensitive information with discretion.
Adheres to all HarborCHC’s policies and procedures.
Conducts self in a manner that represents HarborCHC’s core values at all times.
Must possess a solid commitment to the mission, policies, goals, and philosophy of HarborCHC.
Maintains a positive and respectful attitude with all work-related contacts.
Communicates regularly with his/her immediate supervisor about departmental and HarborCHC concerns.
Consistently reports to work prepared to perform the duties of the position.
Meets productivity standards and performs duties as workload necessitates.
Maintain strict confidentiality of all data and information.
Demonstrates integrity and accountability for duties and responsibilities.
Performs all job functions in a professional and courteous manner. This includes answering phone calls and emails in a timely manner.

Responsibilities

Participate in specialized care management/ care coordination programs (e.g. Enhanced Care Management ECM) by engaging eligible patients to participate in program, assessing patients’ needs, and collaborating with patients and their family/ support persons to develop their comprehensive, individualized, person-centered care plan. PCC will also be responsible for proper and timely documentation in Electronic Health Records.
Assist patients in completing initial paperwork and psychosocial/ health risk assessments during initial intake as appropriate.
Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers. Participate in community meetings.
Provide referral services to patients in need of housing, food, clothing, legal assistance, shelters, substance use disorder (SUD) services, or other services directly related to social determinants of health.
Assist patients in problem-solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
Assist patients in completing applications for financial assistance programs, legal services, disability, immigration, DMV, DCFS, and EDD etc.
Meet with patients on the spot as requested by providers for care coordination or for “warm hand-off”.
Assist with screenings and assessments such as PHQ-9; conduct brief interventions with patients as needed.
Participate in specialized care management program outreach (e.g. Enhanced Care Management) by engaging eligible patients to participate in program, assessing patients’ needs, and collaborating with patients and their family/ support persons to develop their comprehensive, individualized, person-centered care plan. PCC will also be responsible for proper and timely documentation in EHR.
Complete required trainings (universal precautions, blood borne pathogens, risk management, safety drills, customer service, cultural sensitivity, ECM basic training etc.) on a timely basis.
Maintain patient confidence and protect operations by keeping patient care information confidential as determined by HIPAA regulations.
Perform all other related duties as appropriate and/or as assigned.