The Case Management Coordinator Outpatient conveys the purpose and services of the case management programs to the user population. This job provides basic health information, collects data and performs clerical duties that support both the Nurse Case Manager and Social Worker. The Case Management Coordinator Outpatient also works with the health care team in support of case management goals, care transitions and health literacy to optimize patient care.
Essential Job Functions & Accountabilities: Screens referred patients for additional services provided by the Outpatient Case Management Department. Supports patients in accessing health related services, including but not limited to, obtaining and ensuring appropriate use of a medical home and overcoming barriers to obtaining needed medical care and social services. Establishes trusting relationships with patients and their families while providing general support and encouragement.
Uses electronic resources and registries in collecting, reporting, gathering and documenting data for the case management process. Assists with monitoring preventive health care screenings and open care gaps and conducts outreach to link the patients back to their medical home to have the screenings completed. Serves as a point of contact by phone and in person for patients receiving case management and social work services and others for follow-up activities.
Performs face-to-face contacts in the patient’s home, hospital, or medical home settings as needed. Local travel may be required to perform duties at multiple sites. Schedules post discharge follow up and general well visit appointments, determines appropriate care management services, and performs intake screening and general care coordination activities.
Performs a range of non-clinical case management functions including but not limited to outreach, social support, resource linkages, interpretation/translation, transportation coordination and medication co pay assistance coordination. Identifies patients with limited literacy levels and assists with completing complex health forms, locating and linking providers and services. Provides patients with appropriate materials to supplement basic health education and encourages patients to be active and engaged in their health and wellness.
Conducts transitional care visits with Nurse Case Manager and/or Social Worker to prepare the patient for a successful transition back into the community with discharge access to primary care. Identifies need for advance directive assistance and reports finding to Social Worker. May act as preceptor for newly hired Case Management Coordinators, assist with quality improvement activities, and participate in special case management projects.
Promotes individual professional growth and development by meeting requirements for mandatory skills competency, build leadership skills for yourself and others in the department. Performs delegated department operational duties as assigned.
is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.