Clinical Assistant - CNA, CMA, PCT

Position Description

This Clinical Assistant with (Quality Care Coordination) SOM Performance Improvement combines professional medical support duties with a vibrant, upbeat culture while emphasizing TEAMWORK, patient advocacy, positive energy and a supportive workplace environment.

• Works closely with patient outreach, including patients identified by clinicians with Social Determinants of Health (SDOH) needs, to assist patients with connecting to local and state resources for assistance with health equity needs.
• Assist in identifying high-risk patients.
• Conducts post-discharge follow-up calls to patients and caregivers, utilizing specific clinical protocols, Transitional care management (TCM).
• Assists with patients' care as they move between health care settings, such as from hospital to home, to prevent complications, hospital readmissions, and improve health outcomes to ensure a seamless transition, enhance the continuity of care, and empower patients to manage their health effectively.
• Reconciles the discharge medication list.
• Promotes and reinforces patient-centered medical home concepts with patients, their families, and clinic personnel.
• Works proactively to prevent complications, reduce hospital readmissions, and manage patient populations by identifying and addressing quality gaps in care needs.
• Audits charts utilizing custom report data, identifies and reports alterations in patient responses to assist in the identification of problems and formulation of goals/ outcomes and patient-centered plans of care in collaboration with patients, their families, and the interdisciplinary health care team.
• Assists in determining the physical and mental health status, needs, and preferences of culturally, ethnically, and socially diverse patients and their families.
• Participates in the identification of patient needs for referral to resources and facilitates continuity of care.
• Communicates patient data using EMR to support decision-making to improve patient care.
• Collaborates with an interprofessional team.
• Attends and participates in Care Coordination TEAM activities, including but not limited to staff meetings, educational activities, etc.
• Completes Annual Nursing Core Competency Training and maintains current required licensure.

as assigned by supervisor

A minimum of a High School diploma or equivalent. Graduation from an approved certified program for assistants in the area of required specialty. Certification by an approved accredited certifying agency in the specialty in which the particular work will be performed.

• Knowledge and/or experience in care coordination and/or case management.
• Knowledge and/or experience in value-based HEDIS quality care gap measures.
• 1-2 years working experience in one of the following healthcare settings: clinical, hospital, or home-care experience.

Resume / CV

Professional License/Certification

TTUHSC is committed to creating an environment where our team members can do their best work, with programs and benefits to support head-to-toe well-being. Explore just a few of the advantages of being a TTUHSC team member:

• Health Plans + Supplemental Coverage Options – Individual health insurance provided at no cost for full-time team members
• Paid Time Off – Including holidays, vacation, sick leave and more
• Retirement Plans
• Wellness Programs
• Certified Mother-Friendly Workplace

Additionally, TTUHSC invests in the success of our team members by providing opportunities for personal and professional growth, including lifelong learning programs, recognition programs, and health and wellness initiatives. Team members also enjoy a variety of other perks, such as special membership rates at local gyms and golf courses, access to state-of-the-art software and facilities, and discounts on travel, technology, entertainment and more.