Full-Time Medical Assistant Care Coordinator

Summary: The Medical Assistant Care Coordinator works under the direct supervision of the Manager of Chronic Care Coordination and is responsible for monitoring patient health status, following up on directed care by providers and orchestrating seamless care for the patients. The Medical Assistant Care Coordinator interacts with patients and families via phone calls and emails to ensure comprehensive care.

Education: High School Diploma. Certified Medical Assistant (CMA) or equivalent or Licensed Practical Nurse (LPN) licensure required.

Experience: Minimum 2 years of recent clinical experience.

Essential Job Functions

• Meets with office staff monthly to provide updates
• Coordinates and collaborates with medical staff involved in the care of the patient; ensuring all preventative health opportunities are discussed and conducted, as appropriate.
• Evaluates areas of concern, and assists patients with their health care needs, including medical record retrieval, community resources, medication assistance, etc.
• Provides ongoing education and outreach to support patient's achievement of self-management
• Participates in monthly CCM team meetings
• Obtains patient consent and creates an annual patient driven care plan based on health goals that the patient, with the help of their primary care provider, sets for their chronic conditions indicated in their active problem list.
• Maintains accurate and complete documentation within the EMR and other electronic databases.
• Assist in coordination of care with primary care physician, specialists, patient, insurance companies, and other providers in the community.
• Performs timely follow up calls and collects health information through patient outreach.
• Performs telephonic outreach to an identified population with chronic diseases, including, but not limited to: diabetes, asthma, hyperlipidemia, heart failure, hypertension, etc. in an effort to improve the quality of their care
• Utilizes a tracking tool to monitor patients in the Chronic Care Management (CCM) program and patients who are eligible to be in the CCM program, etc.

This list is not meant to be restrictive, totally inclusive, or limited in employee assignment or responsibilities.

Performance Requirements

Knowledge, Skills and Abilities

• Knowledge of general health care practices, office work-flows, and medical terminology
• Strong computer skills, including Microsoft office and EMR experience preferred
• Ability to work autonomously and be directly accountable for assignments
• Strong working medical knowledge of the clinical needs and disease processes for the chronically ill population
• Must have good verbal and written communication skills

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephone, calculators, etc.

Work Environment: Position is primarily in a well-lighted office environment. This position may require limited local travel throughout the business day.

Mental/Physical Requirements: While performing the duties of this job, the employee is regularly required to talk or hear. The employee is primarily sitting at a desk utilizing a computer.

DISCLAIMER

The above information is intended to describe the general nature and level of work being performed by people assigned to this job. It is not intended to be an exhaustive list of responsibilities, duties and skills required of personnel so classified. Examples listed do not preclude the performance of other duties similar in nature or in level of complexity.