Population Health Care Coordinator

Description

Immediate Supervisor Title: Quality Improvement/ Risk Management (QI/RM) Director

This position is responsible for gathering and organizing patient data. The Population

Health Coordinator works to identify patient’s unmet needs, engage patients in their own

care, gather summary information for treatment interventions, and enhance

ongoing communication between the patient and her/his care team. This position

collaborates with the QI/RM Director and Chief Medical Officer (CMO) to ensure

provider and patient needs are met.

Essential Job Responsibilities:

1. Contacts our patients who have been identified as having unmet needs in their

care.

2. Empower and educate patients to have knowledge of screenings gaps.

3. Encourages patients to schedule doctor visits to close these gaps with their PCP.

4. Provides the information necessary to overcome concerns, fears and barriers that

might be keeping the patient from closing their gaps in care.

5. Makes appropriate appointments based on what gaps each patient needs closing

based of QI reports.

6. Follows appropriate scripts when calling patients about scheduling their

appointment.

7. Aid in the optimization of clinical workflows.

8. Outreach in the community for patient engagement and community support.

9. Look for possible grant opportunities that would assist the closing of gaps for our

patient population.

10. Other duties as assigned.

Requirements

Education/Experience: Experience (years): Required: 1-2 years

Education: Degree in Public Health, Healthcare Administration or healthcare related field required or equivalent

Experience with quality improvement programs, integration and informatics related to planning and population health management and involving:
Knowledge of NCQA recognition program PCMH, patient engagement surveys and EMR based reporting. Skill in interacting and communicating with patients, physicians and case managers.

Knowledge/Skills/Abilities:

1. Knowledge of medical office/electronic health record software
2. Excellent verbal communication skills
3. Ability to be flexible and work with changing priorities in a fast paced environment
4. Requires excellent problem solving and critical thinking skills
5. Must be able to interact with individuals of all cultures, education, and levels of authority
6. Must be able to function as part of a team
7. Basic medical terminology required

JOB FACTORS:

Physical Requirements: Requires extended periods of sitting. Some lifting less than 25 pounds. Must be able to work within and on a computer system for extended periods of time.