Value Based Care Coordinator

North Florida Pediatrics•Lake City, FL

2d•$16 - $17

About The Position

At North Florida Pediatrics, patients and their parents are the top priority. The Value Based Care Coordinator provides and facilitates clear, timely communication to patients regarding medication questions, physician-authorized prescription refills, referrals, and lab or test results at a clinician’s request. The role also manages patient care across rural networks to improve health outcomes, reduce avoidable costs, and support the transition from fee-for-service to value-based payment models. The coordinator identifies high-risk or chronically ill patients who need closer monitoring, connects local primary care clinics with mobile health units, behavioral health tele hubs, and regional specialists, and conducts preventive outreach between clinical visits. The role uses electronic health records and health information exchanges to track quality metrics and close care gaps across rural settings. The coordinator may back up floor nursing staff during lunches, breaks, and call-offs when instructed by the Care Coordination Manager or Chief Medical Officer. Duties may include escorting patients and parents to rooms, taking and entering vitals and medical history in the EHR, administering vaccines according to standards established by the Chief Medical Officer and the American Academy of Pediatrics, performing basic tests or swabs, and providing excellent bedside manner. Additional special tasks may be assigned by the manager. The position may require travel to other offices within the region and reliable transportation to work.

Requirements

CMA, LPN, or RN certification, or a degree in healthcare administration or social work.
1 to 3 years of clinical or outpatient primary care experience.
Familiarity with EHR systems and population health platforms.
Strong verbal communication, organization, and empathy to guide patients through complex health systems.
Reliable transportation to work and ability to travel within the region if needed.
Ability to see well enough to read emails, documents, and reports.
Ability to hear well enough to communicate with staff, clients, and vendors, and to assess blood pressure manually using a stethoscope.
Ability to move around the office for prolonged periods, including up and down stairs.
Ability to stoop or kneel to pick up items and assist parents and children with tasks such as removing shoes, stepping onto a scale, and positioning for height assessment.
Ability to lift up to 50 pounds.
Ability to type and perform technical tasks.
Knowledge of word processing software such as Google Docs, Microsoft Word, Excel, and PowerPoint; email software such as Microsoft Outlook; and database user software such as Adobe.

Responsibilities

Identify high-risk or chronically ill patients in rural populations who need closer monitoring and intensive management.
Coordinate care among local primary care clinics, mobile health units, behavioral health tele hubs, and regional specialists.
Conduct regular preventive check-ins between clinical visits to keep care plans on track and reduce emergency room use.
Use electronic health records and health information exchanges to track quality metrics and close care gaps across rural settings.
Communicate with patients about medication questions and physician-authorized prescription refills.
Process referrals and provide lab or test results to patients at a clinician’s request.
Back up floor nursing staff during lunches, breaks, and call-offs when instructed by the Care Coordination Manager or Chief Medical Officer.
Escort patients and parents to assigned rooms, take accurate vitals, and upload medical history and vitals into the EHR.
Provide vaccines to pediatric patients according to standards established by the Chief Medical Officer and the American Academy of Pediatrics.
Run basic tests or swabs as needed and provide excellent bedside manner.
Complete special tasks assigned by the manager.
Travel to other offices within the region if needed.