Care Coordinator
hace 5 días
Richardson
Job DescriptionDescription: Do you wake up every morning inspired to solve problems and make a meaningful impact in health care? If so, we want to hear from you. Innovista Medical Center is more than a clinic. It's a community hub. Many still feel unseen, unheard, and unsupported when seeing a health care provider. By putting our patients' needs first, we are transforming what it means to get exceptional care. We don't just treat symptoms. We focus on whole-person health—physical and mental well-being, disease prevention, and thoughtful management of chronic conditions. Innovista Medical Center provides primary care and walk-in services for people of all ages in ten locations in Dallas and Houston. We provide comprehensive healthcare services, including in-office lab work, vaccines, imaging, and telemedicine. Our values help define the patient experience and how we treat each other. • HEARD: Our care starts with listening well to build relationships and trust., • UNDERSTOOD: We offer an experience recognizing every patient's history and background., • IN CONTROL: We provide one place for all primary care needs for the whole family., • ACTIVELY SUPPORTED: We ensure patients are not alone in the care process, which is much more than what happens during a visit. We're thrilled to announce a dynamic opportunity for you to become an integral part of our Dallas, Texas team. As an onsite contributor, you'll play a key role in pioneering a pathway toward a more streamlined and effective healthcare system. JOB SUMMARY At Innovista Medical Center, the Care Coordinator is a key member of the clinical team, working under the guidance of the Supervisor of Care Management. This role serves as a liaison between the insurance company, the Hospital, and Innovista patients, ensuring clear communication and coordinated care. The Care Coordinator is responsible for a range of functions including health service coordination, clinical data analysis to understand the reason behind the patient utilization of healthcare services, population health management, healthcare system navigation, and connecting patients with community and behavioral health resources. The Care Coordinator plays an important role in customer service inside and outside the facility. This position is primarily based in an outpatient setting, with flexibility to support other locations as needed. DUTIES AND RESPONSIBILITIES Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this position. • Identify and assess members for care coordination and case management based on clinical indicators and chronic conditions., • Conduct telephonic assessments to educate and empower members in self-managing their health and wellness., • Develop and monitor individualized care plans in collaboration with Clinical Case Managers, providers, and interdisciplinary care teams. Coordinate care across programs such as Transition of Care (TOC), Complex Chronic Care, ED Diversion, and Gap Closure., • Manage post-discharge and transitional care by scheduling follow-ups, coordinating with hospitals and primary care providers (PCPs), and facilitating safe discharge planning. Collaborate closely with hospital case managers to assess and coordinate post-discharge needs, including durable medical equipment (DME) and home health or hospice services., • Support continuity of care by facilitating the transfer of key clinical information between acute and post-acute providers. Conduct root cause analysis for readmissions and develop mitigation plans to improve outcomes., • Educate patients and families on disease processes, care plans, preventive care, and available resources, including behavioral health services. Promote compliance with preventive care standards and reduce unnecessary utilization., • Document all care coordination activities accurately in the care management system. Track and report outcomes, assist with quality improvement initiatives, and identify quality of care issues for escalation to clinical leadership., • Support care team operations by assisting with scheduling, transportation arrangements, and follow-up coordination. Participate in team meetings, outreach events, and special projects as assigned., • Ensure in-network utilization by redirecting patients to appropriate facilities and specialists., • Abstract hospital medical records for provider review and facilitate transitional care management (TCM) meetings with post-acute partners to evaluate process and performance outcomes. Requirements:, • High school diploma or equivalent required., • Medical Assistant License, • 3-5 years of experience as a Care Coordinator in a health care setting., • Strong knowledge of medical terminology, health maintenance, customer service, and complex chronic disease programs, • Bilingual in English and Spanish preferred,, • Epic EMR system knowledge is highly preferred., • Evidence of communication, education, and counseling skills., • Proficiency in communication technologies (email, cell phone, etc.)., • Highly organized with the ability to keep accurate notes and records., • Clinical Case Evaluation., • Patient and customer management., • Ability to navigate to other clinic locations is required., • CPR/BLS certification required preferred BENEFITS: We are committed to creating a culture where everyone feels important, welcomed, and included. We demonstrate this commitment by offering a comprehensive benefits package that fosters opportunities for growth and advancement and supports the physical, mental, and financial wellbeing of our team members. HEALTH & WELLBEING • A choice health coverage, including HMO and PPO, plus Flexible Spending Account (FSA) and Health Savings Account (HSA) options, • Dental and vision coverage, • Company-paid benefits (short- and long-term disability, employee life, and accidental death and dismemberment), • Employee Assistance Program, • Bereavement Leave (full time employees for the loss of an immediate family member), • Paid Military Leave Benefits, • A yearly discretionary bonus, • 401(k) with a company match, • Credit Union Banking alternative, • Wellness Rewards with Monetary Incentives, • Flexible schedule and work from home options for numerous roles, • Nine paid company holidays + Sick and Wellness Days + accrued PTO, • Commuter benefits, • Clear career advancement and growth pathways, • Continuous education opportunities and financial reimbursement, • Diversity, Equity & Inclusion Committee with various Business Resource Groups you can join, • Company-wide socials and gatherings