Ambulatory Care Coordinator Jobs

Company Description

At UM Capital Region Health, we’re about to changeUP everything with the opening of our new hospital in Spring 2021!

Located at 5001 Silver Hill Road, Suite 202, Suitland, MD 20746, our new state-of-the-art regional medical center (UM Capital Region Medical Center) will provide improved access to primary and ambulatory care services, and serve as a tertiary care center for critically ill patients. In addition, our new space will allow us to expand our offerings as a community partner to help improve the health status of Prince George’s County residents.

Population Health

• Creating patient, physician, and clinic level quality performance reports.
• Works with patients and families on Self-Management Support including:
• Identifies patients overdue for visits, labs, or referrals and arranging for follow up services as appropriate.
• Facilitates patient care services by managing and individualizing care for patients and their families.
• Setting short and long-term goals for self-management of chronic disease.
• Conducts pre-visit chart review of patients including
• Identification of all needed preventive health maintenance, immunizations, and chronic disease interventions.
• Per protocol, initiate interventions before the patient sees a provider.
• Addressing medication adherence in patients not meeting outcome goals.
• Works with patient to create an individualized plan for Health Behavior Change if deemed necessary.
• Completes pre-visit forms or initiates office visits forms to communicate the review to the provider.
• Identifies patients not meeting clinical goals, (for example: BP control or glucose control, anticoagulant therapy) and arranging for follow-up services by protocol or as appropriate.
• Assessing and working on the patient’ readiness to change, the importance of change, and confidence in ability to change.

ii. Helping the patient to identify and overcome barriers.

• Provides or arranges needed patient education regarding specific health care skills and general disease concepts.
• Provides health care advice through telephone calls or the Internet, if applicable.
• Makes a plan for follow-up between visits

Coordination of Care

• Acting as a liaison with hospitalized patients and the clinic. Following up with assigned established
• Assists as liaison with patients and their families to physicians, clinical staff, and other departments.

clinic/office panel patients by phone shortly after hospital discharge or emergency room visit.

• Providing a link to community resources collaborately with social worker/case manager
• Proactively acts as patient advocate, responding to and working to resolve patient concerns.
• Involvement in Performance Improvement activities:
• Communicates and coordinates with the healthcare team (including management, social worker and providers) in the development of tools for optimal patient outcomes and report findings.

Clinical Responsibilities

• Ensures the smooth and timely flow of patients within the clinical area responding to high volumes of

patients in short-term time spans.

• Demonstrate, understand and perform triage activities for all walk-in patients and medical phone

inquiries; using reasonable and astute clinical judgments in order to expedite the appropriate care and treatment of patients.

• Support and ensure accuracy of LPN/Medical assistant who obtain initial information from patients (i.e.: vital signs, symptoms, and complaints) through interviewing patients and reviewing documentation
• Provide nursing care based on physician and mid-level provider orders, to meet the needs (physical, mental, and emotional) of patients
• Provides working oversight and delegates tasks to licensed practical nurses, and non-licensed medical staff.

Qualifications

• 1 year ambulatory care exprience preferred.
• Graduation from an accredited school of nursing is required; a Bachelor’s degree is preferred.
• 3 years of clinical nursing experience within specilaity area is required.
• BLS - Health Care Provider required.
• Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required.

Additional Information

All your information will be kept confidential according to EEO guidelines.