Position Summary:
Population Health at CCI speaks to the systematic process of utilizing data on patient populations to design targeted interventions for better health outcomes at lower cost, resulting in a better care experience. As part of the Population Health team, the Clinical Care Coordinator is responsible for managing the member panel to assist the member in reaching desired patient outcomes and care gap closures, coordinating specific care interventions for patients with identified complex chronic care needs.
This position serves as a liaison between the patient's needs and the resources provided by the care management program.
ESSENTIAL FUNCTIONS:
Panel Monitoring
- Utilizes CipherHealth PHIP and ED/IP programs, daily in response to calls that appear on the program dashboard.
- Monitor the next day's scheduled CipherHealth calls, daily.
- Download the PPMCO 360 Report on the 3rd Friday of each month from the JHHP SFTP site.
- Updates 360 Report with corresponding notes to add information pertaining to each member (e.g. appointments, outcomes, clinical updates, barriers)
- Completes and updates the Outreach Outcomes Report.
Member Outreach
- Make outreach calls using Outreach Call Scripts within the prescribed timetable: First call within 24 hours of the request, 2nd call 2-3 days, 3rd call 7-10 days.
- Schedule appointments following CCI Scheduling Guidelines/Workflows.
- Assist with rescheduling and canceling appointments.
- Assists with transportation arrangements for eligible members
- Coordinates with IT to utilize the Outreach Call Scripts for mass communication during Special Outreach Campaigns.
Monitor Appointment Attendance
- Monitor upcoming appointment dates.
- Confirm appointment attendance and document outcomes in the panel, daily.
Member Engagement
- Coordinate follow-up care plans by scheduling needed appointments or enrolling members in related programs.
- Identify any barriers and coordinate resolution to ensure members receive appropriate care, at the proper level, in a timely manner.
- Ask follow-up questions and listen actively to identify patient questions or issues while documenting required information in computer systems
- Investigate inquiries, provide needed follow-up, and document actions required to service the inquiryPage Break
Other Administrative Duties:
- Leverage lessons and curriculum from toolkits and best practices; share winning strategies with care management staff.
- Assist with clinical data collection and generate dashboards and reports as assigned.
- Analyze data to ensure performance compliance.
- Participates in clinical quality improvement initiatives.
Education/Work Experience:
- Associates degree required; bachelor’s preferred.
- One (1) year related healthcare experience.
- Bilingual, a plus.
WORKING CONDITIONS:
- Proper and professional grooming is always expected.
- Prolonged periods of standing, bending or working at a desk on a computer.
- The ability to lift (up to 15lbs) is required.
- Work under stressful conditions within a controlled enclosed environment daily. The work environment involves exposure to potentially dangerous materials and situations that require extensive safety precautions and may include the use of protective equipment.
- ADA Category. In accordance with the American with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodation will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization.
- OSHA Category 1. Clinical environment. Possibility of exposure to chemicals and infectious body fluids e.g., HPV, HIV, HEP C, HSV.
Why work at CCI?
- Extensive benefits plan including PTO
- 403B Retirement Plan
- Tuition reimbursement opportunities
- Continuing education assistance; can be used toward obtaining certifications, renewal of certifications, or possible conference attendance.
- Our providers are insured for malpractice under FTCA.
60000.00 To 75000.00 (USD) Annually
