Clinical Care Coordinator

Job Summary and Qualifications

As the Clinical Care Coordinator, you will be accountable for ensuring a high standard of quality and coordination of care in support of a Clinically Integrated Network (CIN). You will monitor progress toward network goals, quality care gap management, transitions of care for identified populations, and care coordination to drive quality and cost outcomes for the attributed populations. You will support the CIN care coordination/care management initiatives, which may include outreaching, triaging, and providing care navigation for patients attributed to the CIN.

• Conduct outbound calls to patients recently discharged from the hospital or ER to ensure appropriate follow up with primary care providers
• Conduct outreach and follow up in regard to patients that are high and medium risk and gaps in care
• Complete a standard assessment for clinical, behavioral, and community needs, triage for additional support by licensed clinical staff, and complete referrals to additional resources as needed
• Provide patient education relative to navigating the health care system and community resources
• Collaborate with providers and practice teams to communicate patient needs and develop solutions to overcome barriers
• Collaborate with the payer system and payer Care Coordinators on specific patient care needs
• Support the efforts of providers and practice teams on office-based care delivery interventions
• Test and pilot new initiatives and work with leadership on refining processes, helping the CIN achieve contractual metrics
• Review reports from payers and assist the Director in the interpretation of the reports and actions needed
• Assist in the development, implementation and monitoring of CIN policies and procedures as they relate to value-based programs

• 5 years of healthcare experience in primary care, care management/coordination, or other related field
• Managed care understanding regarding value-based payer contract requirements
• Great communication and phone skills
• Certified CMA required

St David's Care Partners offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support
  , including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources
  , including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits ()

Eligibility for benefits may vary by location.

The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual.

- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.