Care Coordinator - ECM v4

SAC Health; Indio (CA); On-site; USD 34,000 - 55,000; Full time

Benefits offered by this job

Sick Leave

Paid Holidays

Retirement - up to 8% employer

Continuing Education and Learning

Annual Mission Trip

Job summary

SAC Health in Indio, CA is seeking a Care Coordinator, ECM to manage utilization reviews, discharge planning, and patient services coordination. You will collaborate with insurers, clinicians, and families to develop integrated plans of care and ensure smooth transitions across care settings.

Responsibilities include intensive case management for chronic conditions, data analysis, and engaging patients through in-person or telephonic outreach.

Qualifications

• High School Diploma or GED required; Medical Assistant program completion required.
• Certified Medical Assistant program completion and CPR/BLS certification required.
• California driver's license and EPIC certification required for module.

Responsibilities

• Perform intensive case management for low to moderate risk patients with chronic conditions.
• Collaborate with patients and care team to build integrated plans of care.
• Engage in data analysis and manage patient databases for care coordination.
• Monitor follow-up, order diagnostics as needed, and assist with care plan adherence.
• Support transitions from higher levels of care to home, including medication reviews.

Skills

Communication skills

MS Office proficiency

Analytical thinking

Time management

Education

High School Diploma or GED

Medical Assistant Diploma/Certificate

Associate degree preferred

Tools

EPIC

Electronic Health Records (EHR) systems

MS Office

Job description

Who We Are

SAC Health empowers our patients and their families to live vibrant and healthy lives through culturally responsive, exceptional care. Patient-centered, whole-person care. Our unique, full scope, team-based approach is what makes SAC Health the provider of choice for patients.

Top-Tier Patient Satisfaction Scores | Largest Teaching Health Center FQHC | 11 Locations offering 44 Specialties | Participation in NHSC & NCLRP loan forgiveness programs

What We Are Looking For

The Care Coordinator, ECM manages cases regarding utilization review, discharge planning, and patient services coordination. Collaborates with insurers, managed care organizations, referral providers, patients, and families to assist in developing case management guidelines.

Schedule: 5 days per week, 8 hours per day, Monday - Friday, 7:30am-4:00pm | Location: Indio Clinic, Indio, CA

ESSENTIAL FUNCTIONS AND DELIVERABLES

• Performs intensive case management for a caseload of low to moderate risk patients with chronic medical, behavioral, or substance use health conditions.
• Collaborate with patients and the care team to build integrated plans of care to address medical, behavioral, and social support needs. Patient engagement will meet program expectations and ensure comprehensive, coordinated care.
• Participate in Systematic Case Reviews. Present patient needs in a prioritized and organized manner and assist in developing a plan of care for patients based on integrated feedback.
• Compile and analyze patient data/team data to provide prioritization and informed feedback to management. Will oversee patient/team databases and ensure accuracy of data.
• Actively monitor results to ensure appropriate follow-up and diagnostic studies are ordered and completed, as appropriate. Assist patients in following through on their care plan wellness goals, using both phone and in-person contact.
• Assist patients discharged from higher levels of care with transitioning to home. This may include medication reviews, referral follow-up, and linkage to external services. Perform transition of care assessments. Collaborate with the care team to ensure successful transitions.
• Work within a team of nurses, behavioral health clinicians, and patient navigators to ensure patient health needs are met. This will include engaging patients, building rapport, and establishing trusting relationships with patients and their care teams.
• Maintain active collaboration with the care team and extended network of care providers. Effectively communicate across the health care continuum to ensure patient needs are met.
• Engage and enroll new patients into the program through in-person or telephonic outreach. Work with team members to ensure team caseloads meet programmatic expectations. Gain a thorough understanding of program eligibility and expectations. Assist patients in maintaining eligibility to participate in the program.
• Meet value-based measurement expectations through data-driven, measurement-based care. Utilize reports to prioritize and organize daily work.
• Home and/or community-based visits may be required based on patient and team needs; must have a reliable vehicle, valid driver's license, and auto insurance.
• Attend and participate in staff meetings, in-services, staff development, educational courses, workshops, and conferences.
• Other duties as outlined in the official job description.

QUALIFICATIONS

• Education: High School Diploma or GED required. Graduation from a Certified Medical Assistant Program is required. Associate degree preferred.
• Licensure/Certification: Medical Assistant Diploma/Certificate and Current CPR/BLS certification (must be American Heart Association or Red Cross accredited program). Valid California driver's license, and auto insurance is required. As a requirement of this position, you must receive EPIC certification for the module you have been hired into.
• Experience: 2+ years as a Medical Assistant or related field required.
• Essential Technical/Motor Skills: Must be proficient in MS Office Suite (Word, Excel, PowerPoint, Outlook). Must be able to use widely support internet browsers. Must have the ability to use variations of electronic health records and other various databases.
• Interpersonal Skills: Must have excellent communications skills both orally and in writing. Must possess the ability to communicate with and relate to a diverse group of people including patients, community, and other staff. Must have strong conflict and problem resolutions skills.
• Essential Mental Abilities: Must be flexible to perform a variety of tasks. Must be well organized and a self-starter. Must have strong analytical and problem-solving skills.
• Work Eligibility: Must be legally authorized to work in the United States on a full-time basis. Must not now or in the future require sponsorship for employment visas.

EEO

SAC Health is committed to fostering a diverse, equitable and inclusive work environment and is committed to being an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Full Benefits Package

• Industry Leading PTO Accrual (accrued per pay period)
• Sick Leave
• Paid Holidays
• Paid Jury Duty, Bereavemen t
• SAC Health Covers approximately 85% of Team Member health premium costs (may vary w/benefit plan selection)
• Retirement - up to 8% employer contribution
• Continuing Education and Learning Benefits
• Annual Mission Trip
• and much more!

Learn More About the Work We Do:

SAC Health's Mission: SAC Health's mission is to reflect the healing ministry & love of Jesus Christ through healthcare, education & partnerships that empower our communities to flourish.

SAC Health's Core Values: Quality Healthcare - Teamwork - Wholeness -Integrity - Compassion - Excellence - Humble Service - Respect