Care Coordinator II

Publicado por
La Clinica del Pueblo
Washington, DC
Publicado há 18 dias

La Clínica del Pueblo

Job Description

 Job Title:                            Care Coordinator II

Department:                    Nursing and Care Management

 Supervisor:                       Director of Nursing and Care Management

 Location:                           The position will work in Washington, DC and Hyattsville, MD

                                             will be working in both locations.


Classification:                 Non-Exempt/Hourly


The Care Coordinator II works within care management teams to implement patient- centered care plans through appropriate linkages, referrals, coordination, and follow-up to needed services and support. The Care Coordinator II works in collaboration and continuous partnership with chronically ill and/or “high-risk” patients and their family/caregiver(s), LCDP staff, and external providers and agencies with the goal of enhancing patient health and well-being, increasing access to needed supports, and improving the patient experience.


Required Education and Experience:                   

·        Bachelor’s degree in human resources or related field

·        Two years prior experience in Health & Human Services field

·        Bilingual in English and Spanish

·        Excellent oral and written communication skills

·        Experience in care coordination and/or case management

 Preferred Education and Experience:

·        Experience working in Latino community

·        Experience working with persons living with HIV or at high risk of HIV to transmission

·        Local knowledge about and connections to community health care and social welfare resources

·        Highly organized with the ability to keep accurate notes and records

·        Core values consistent with a patient- and family-centered approach to care

·        Working knowledge of electronic health records

·        Experience working in dynamic and fast paced team environment

·        Experience working in multi-disciplinary teams

Required Skills/Abilities/Certifications/Licenses:

·        Understanding of basic principles of research and evaluation design

·        Proficiency with Microsoft Office; advanced skills in Microsoft Excel

·        Ability to analyze data and present information in graphical or tabular form.

·        Excellent organizational and communication (verbal and written) skills.

Preferred Skills/Abilities/Certifications/Licenses:

·        Project Management Certificate

·        Certified Health Education Specialist


Duties and Responsibilities

1.      Implement care coordination plan for chronically ill and/or “high-risk” patients assigned for care management and care coordination, through appropriate linkages, referrals, coordination, and follow-up to needed services and support. Services may include:

a.      Schedule appointments and providing telephonic reminders of appointments.

b.      Assist the individual in navigating health, behavioral health, and social services systems, including housing as needed.

c.      Community-based outreach and follow-up, including face-to-face contact with individuals in settings in which they reside, which may include shelters, streets, or other locations for unsheltered persons.

d.      Telephonic outreach and follow-up to individuals who do not require face-to-face contact.

e.      Ensure that all regular screenings are conducted through coordination with the primary care or other appropriate providers.

f.       Assist with medication reconciliation.

g.      Assist with arrangements such as transportation, directions, and completion of durable medical equipment requests.

h.      Obtain missing records and consultation reports.

i.        Encourage the individual’s decision-making and continued participation in the care plan.

j.        Participate in hospital and emergency department transition care.

k.      Document in the certified EHR (Electronic Health Records)

l.        Ensure that the individual connects to systems of eligibility for public benefits, including Medicaid.

2.      Develop case management service plans to support client’s increase access to support services, including completing all required activities for needs assessment, service plan with measurable goals and objectives, monitoring of plan, and updates as indicated.

3.      Provides patient-centered motivational interviewing techniques to build rapport to help patients to improve health outcomes.

4.      Provide individual and family support in identifying and meeting their range of biopsychosocial needs and accessing resources. These services include but are not limited to medical transportation; language interpretation; appropriate literacy materials; housing assistance; and other benefits to which they may be eligible or need.

5.      Provide referrals to community and social support to connect clients with referrals to a wide array of support services that will help them overcome access or service barriers, increase self-management skills, and achieve overall health outcomes.

6.      Provide benefits counseling and support to assist eligible clients in obtaining access to public and private programs for which they may be eligible, including but not limited to Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer’s Patient Assistance Programs, other state or local health care and supportive services, and health insurance plans through health insurance Marketplaces/Exchanges.

7.      Follow all protocols and procedures required by funders and by La Clinica del Pueblo regarding care coordination duties and responsibilities

8.      Demonstrate professional, appropriate, effective, and tactful communication skills, including written, verbal, and nonverbal

9.      Demonstrate a positive attitude and respectful, professional customer service

10.  Acknowledge patient’s rights on confidentiality issues, always maintains patient confidentiality, and follows HIPAA guidelines and regulations

11.  Proactively act as patient advocate, responding with empathy and respect to resolve patient and family concerns, and recognize opportunities for improvement to meeting patient concerns

12.  Proactively continue to educate self on providing quality care and improving professional skills

13.  Maintain medical records including completeness, filing, neatness, confidentiality, and documentation.

14.  Attend required internal and external program meetings.

15.  Complete monthly reports as assigned

16.  Meet with supervisor as required.

17.  Provide other activities as identified by your supervisor.

Supervisory Responsibilities: N/A

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer 

La Clínica del Pueblo

Job Description

 Job Title:                            Care Coordinator II

Department:                    Nursing and Care Management

 Supervisor:                       Director of Nursing and Care Management

 Location:                           The position will work in Washington, DC and Hyattsville, MD

                                             will be…

Resumo dos Detalhes

  • Comprometimento de Tempo
    Carga Horária Integral
  • Educação
    Ensino Superior Requerido

Nível de Proficiência do Idioma

·        Bilingual in English and Spanish

·        Bilingual in English and Spanish


2831 15th Street, NW, Washington, DC 20009, United States

Como se inscrever

Inscreva-se no Idealist

Inscreva-se hoje para salvar Empregos e assim receber alertas de emails toda vez que novos anúncios forem publicados.