Care Coordinator II

Sea Mar Community Health Centers; Everson (WA); On-site; USD 28,929 - 34,440; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Life insurance

Long-term disability

Paid time off

Job summary

Sea Mar Community Health Centers seeks a Care Coordinator II to manage care for patients with chronic conditions and behavioral health needs at the Everson Medical Clinic. You will participate in daily huddles, identify patient needs, and provide point-of-care services to improve quality and patient-centered care.

The role requires strong organizational, communication, and confidentiality skills, with Spanish language fluency preferred.

Qualifications

• Knowledge of the Patient-Centered Medical Home model and motivational interviewing is a plus.
• Familiarity with evidence-based standards of care for chronic conditions and behavioral health.
• Ability to document patient information in the Electronic Health Record.
• Spanish language fluency is strongly preferred; other languages welcome.

Responsibilities

• Participate in morning huddles to anticipate patients’ clinical, social and behavioral health needs.
• Collaborate with the care team to identify gaps in care and implement process-improvement strategies.
• Provide brief interventions at the point of care to manage chronic illnesses and link to behavioral health resources.
• Advocate for patient services with community, social service, and medical providers.
• Coordinate care transitions for patients discharged from hospitals, ERs or long-term care facilities.
• Track adherence to the care plan and communicate outcomes to the primary care provider.
• Lead quality improvement activities and organize monthly Health Home meetings.
• Document performance and monitor sustainability of quality measures.

Skills

Care coordination

Chronic disease management

Behavioral health

Multidisciplinary teamwork

Patient engagement

Communication skills

Spanish language fluency

Confidentiality

Time management

Privacy and security

Interpersonal skills

Education

LPN with ambulatory care experience

BA/BS/BSW in health-related field with 1 year community health

4 years of equivalent experience

BLS CPR within 90 days

NCQA certification is a plus

Washington State driver's license

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

Electronic Health Record

Job description

Sea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, offers comprehensive health, human, housing, educational, and cultural services to diverse communities, specifically serving Latinos in Washington State. All persons are served without regard to race, ethnicity, immigration status, gender, or sexual orientation, regardless of ability to pay.

Position: Care Coordinator II (Full-time)

Hourly Rate: $22.63

Vaccination Policy

Sea Mar requires mandatory COVID‑19 and flu vaccinations for all employees.

Position Summary

Full‑time position at Everson Medical Clinic. The Care Coordinator will coordinate care for patients with chronic conditions and behavioral health needs at the point of care. As a member of the Clinical Care Team, the Coordinator will participate in daily huddles, identify patients’ needs according to protocols, and provide point‑of‑care services to enhance quality and patient‑centered care.

Duties and Responsibilities

• Participate in morning huddles to anticipate patients’ clinical, social and behavioral health needs.
• Collaborate with the care team to identify gaps in care and implement process‑improvement strategies.
• Provide brief interventions at the point of care to help patients manage chronic illnesses, address social needs, and link to behavioral health resources.
• Advocate for patient services with community, social service, and medical providers.
• Coordinate care transitions for patients discharged from hospitals, ERs or long‑term care facilities.
• Track patients’ adherence to the plan of care in electronic or paper charts and communicate outcomes and recommendations to the primary care provider.
• Act as the point person on chronic disease management and quality improvement activities to improve clinical quality measures.
• Organize monthly Health Home meetings, create agendas and facilitate meetings.
• Collaborate with the clinical care team to improve Patient‑Centered Medical Home processes and provide documentation of performance.
• Review medical records for quality and utilization indicators as outlined in the Quality Improvement Plan.
• Generate reports for care teams to identify improvement areas and monitor sustainability of each quality measure.

Qualifications and Experience

• Ability to work independently, prioritize workload, and meet deadlines.
• Critical thinking skills and discretion to maintain confidentiality.
• Excellent organizational skills and ability to manage multiple tasks simultaneously.
• Knowledge of medical terminology and/or behavioral health topics.
• Strong decision‑making and prioritization abilities.
• Respectful and professional interaction with community, patients, families, and staff.
• Effective work in a multicultural environment with a diverse population.
• Sympathetic, mature, responsible, and reliable.
• Strong patient engagement, interpersonal, and communication skills to establish therapeutic relationships.

Knowledge, Skills and Abilities

• Knowledge of the Patient‑Centered Medical Home model and motivational interviewing skills is a plus.
• Familiarity with evidence‑based standards of care for chronic conditions and behavioral health.
• Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook.
• Ability to document patient information in the Electronic Health Record.
• Knowledge of community resources.
• Comfortable working in a fast‑paced community health care setting.
• Analytical and problem‑solving skills in multidisciplinary and independent contexts.
• Effective communication with diverse communities.
• Time‑management and task‑prioritization.
• Analysis of patient care data.
• Assessment of client learning needs and knowledge readiness.
• Maintenance of privacy and security of sensitive information per local, state, and federal privacy requirements.
• Excellent communication and customer‑service skills.
• Critical thinking.
• Process improvement implementation.
• Spanish language fluency is strongly preferred; other language skills considered based on site needs.

Education, Certificates, Licenses and Registrations

• LPN with experience in ambulatory care, or BA/BS/BSW in health‑related field with one year of community health experience, or four years of equivalent experience (no active license required).
• Must obtain Basic Life Support (BLS) CPR within 90 days of hire and maintain it throughout employment.
• NCQA certification is a plus.
• Valid Washington State driver’s license and proof of liability insurance.

Benefits

• Medical, dental, and vision coverage.
• Prescription coverage.
• Life insurance.
• Long‑term disability.
• Employee Assistance Program.
• Paid time off starting at 24 days per year plus 10 paid holidays.

Full‑time employees working 30 or more hours per week receive the above benefit package.

401(k) and retirement options are available.

How to Apply

Please complete the online application and submit. For questions, contact Karyn Ramirez, Nurse Manager, at [e-mail].

Equal Opportunity Employment

Sea Mar is an Equal Opportunity Employer, committed to a diverse workforce and inclusive environment.