Value-Based Care Clinical Coordinator

Patient First•Glen Allen, VA

1d•Onsite

About The Position

The Value-Based Care Clinical Coordinator assists Nurse Care Managers (NCMs) in facilitating patient care, closing clinical gaps, and ensuring continuity of care. This role involves coordinating external resources, managing patient outreach, educating patients and caregivers, and supporting the day-to-day operations of the NCM department. The coordinator acts as a liaison between patients, healthcare providers, and various clinical support resources, utilizing the electronic medical record system and payer-specific systems to manage patient needs effectively.

Requirements

Must be eighteen years of age or older.
At least 3 years of experience as a Medical Assistant, preferably within a Patient First center.
Experience in scheduling appointments with multiple providers, including diagnostic testing.
Ability to work in a team-oriented environment and be highly organized.
Ability to work and communicate effectively with all levels of administrative and professional personnel.
Exceptional oral, written, and telephonic communication skills.
Self-disciplined, self-directed, motivated, energetic, passionate, and innovative.
Must be able to sit, stand, and walk for long periods of time.

Nice To Haves

Associate degree preferred.

Responsibilities

Assisting Nurse Care Managers (NCMs) by facilitating outside specialty referrals, scheduling diagnostic testing, or aiding in collaborative care efforts as directed.
Coordinating external clinical resources efficiently according to NCM directives and care plans using the resources available.
Collaborating with department leadership to support and improve the effectiveness and efficiency of clinical practices and processes.
Understanding the electronic medical record system, NCM module, and payer-specific systems.
Developing and maintaining strong relationships with patients, Patient First Physicians, ancillary staff, and external clinical support resources to ensure continuity of care.
Conducting telephonic outreach to patients to encourage clinical gap closure, including: Providing telephonic advice per Patient First and Value-Based Care-specific instructions, maximizing the patients’ health, wellness, safety, and self-care capabilities by closing care gaps and helping with coordination of patient self-care needs, and scheduling and facilitating conversations with NCMs.
Educating patients and caregivers on the importance of specified preventive or chronic care gaps.
Assisting patients with appointment scheduling.
Conducting follow-ups with patients to ensure compliance with recommendations and follow-up appointments as needed.
Coordinating any necessary clinical information to support specialist appointments and transitions of care between in-patient, specialty, and primary care settings.
Communicating necessary patient updates, escalating clinical needs, and ensuring an effective handoff has been made to the assigned NCM.
Facilitating the transfer of all urgent and emergent calls to an NCM or the Quality Improvement Committee (QIC) Project Director.
Developing a list of medical and community resources available to patients and maintaining collegial relationships with frequently used organizations.
Facilitating continuity of care on behalf of the patient to ensure successful closure of care gaps.
Fostering positive relationships with and effective communication between Patient First, consulting physicians, hospitals, and other frequently used health care resources.
Assisting with the day-to-day operations and administrative needs of the NCM department.
Completing assigned checklists within the assigned shift.
Receiving and storing supplies, as well as restocking the NCM area as needed.
Attending staff meetings as scheduled by the NCM Supervisor.
Handling NCM requests in a timely manner.
Operating and maintaining office equipment as trained.