Care Coordinator - Napa

Ole Health; Napa (CA); On-site; USD 40,000 - 50,000; Full time

Benefits offered by this job

Medical/dental/vision premium covered

PTO 18 days (Vacation & Sick)

10 paid holidays + 1 float holiday

403(b) retirement plan with 2% match

Tuition reimbursement up to $2,000/yr

Life & accidental insurance

HSA contributions

Job summary

CommuniCare+OLE is seeking a full-time Care Coordinator in Napa, CA. You will partner with patients, families, care teams, and community partners to improve health outcomes and support self-management.

Responsibilities include coordinating referrals, addressing social determinants of health, and creating care plans for high-risk patients. The role emphasizes collaboration, accurate documentation, and ongoing participation in team activities.

Qualifications

• BLS certification is required.
• Strong collaborative skills and ability to engage care teams.
• Experience working with diverse populations preferred.
• Experience in community health setting preferred.

Responsibilities

• Evaluate social determinants of health and identify barriers to care.
• Process and close the loop for community resource referrals.
• Provide warm hand-offs for urgent medical referrals and coordinate with referral teams.
• Support quality improvement initiatives with the BH Manager, Care Coordination.
• Meet with new patients and orient them and their families to the program.
• Participate in huddles, team meetings, and case conferences as needed.
• Educate patients about community resources and services.
• Coordinate warm hand-offs for integrated care providers.
• Support primary care providers with forms and tasks as needed.
• Care manage and create care plans for high-risk patients.
• Document timely in the EMR and comply with ECM processes.
• Cover care coordination duties when colleagues are out of the office.

Skills

BLS Certification

Collaborative skills

Care coordination

Education

High School Diploma or equivalent

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

3 days ago Requisition ID: 2503

Salary Range: $29.32 To $35.83 Hourly

POSITION TITLE:

DEPARTMENT:

Care Coordination

REPORTS TO TITLE:

BH Manager, Care Coordination

LOCATION:

PAY RANGE:

$29.32 to $35.83/hr (depending on years of care coordination experience)

SCHEDULE:

Monday to Friday, 8am to 5pm (full time)

DLSE/FLSA STATUS: ( )

__ __Nonexempt/Hourly position

SUPERVISORY RESPONSIBILITIES (does this position have direct reports):

NO

About CommuniCare+OLE

Established in 2023, CommuniCare+OLE is the result of a union of two health centers with a deep roots in their respective communities and reputations for providing high-quality primary care to all, regardless of insurance or ability to pay: OLE Health of Napa and Solano Counties and CommuniCare Health Centers of Yolo County. Building on a legacy established by both organizations in 1972, CommuniCare+OLE is a network of federally-qualified health centers with 17 sites across Napa, Solano, and Yolo Counties. It offers comprehensive care, including medical, dental, behavioral health and substance use treatment, nutrition, optometry, pharmacy, care coordination, referrals, and enrollment assistance to more than 70,000 individuals, and no one is turned away due to lack of insurance, immigration status, or ability to pay. Many services are offered outside of its sites, including mobile health, home visiting, and community and school-based programs.

BENEFITS

• Employer covers 90% of employee medical, dental and vision premium and 50% of dependent premium
• 18 days of PTO (Vacation & Sick)
• 10 Paid Holidays + 1 Float Holiday
• 2% employer match with employee 4% Contribution 403(b) retirement plan
• Tuition Reimbursement of up to $2,000 per Calendar Year for part-time and full-time employees (prorated per Full-Time Equivalent)
• Life & Accidental Insurance Coverage
• Employer contribution for Health Savings Account

JOB SUMMARY/OVERVIEW:

The Care Coordinator works in continuous partnership with the patient, their family when appropriate, their care team, and relevant community partners to improve health outcomes and meet the patient’s desired health and wellness goals by:

• Serving as the contact point, advocate, and informational resource for patients, family/caregiver(s), primary care team, payers, and community resources
• Facilitating access to internal and external services
• Identifying and addressing gaps in care and assessing for social determinants of health
• Increasing patient’s ability for self-management and shared decision-making

CommuniCare+OLE provides an inclusive workplace that promotes and values diversity and life experience.

CommuniCare+OLE encourages people of all backgrounds to apply including, but not limited to, Black, Indigenous Peoples,

people of color, immigrants, refugees, women, LGBTQIA+, people with disabilities, veterans, individuals of

all ages and religions, and individuals who have been affected by the legal system.

YOU ARE WELCOME HERE.

***The following reflects requirements and essential functions of this position but does not restrict tasks that may be assigned. Essential functions include basic job duties, core elements, or fundamental responsibilities that an employee must perform to hold the position. Employees must be able to perform these essential functions with or without reasonable accommodation (accommodation may be requested). Duties and responsibilities are not all-inclusive, and they may be assigned or reassigned to this job at any time, due to reasonable accommodation or any other reason. ***

MINIMUM POSITION REQUIREMENTS: EDUCATION, EXPERIENCE, SKILLS/TRAINING

• Education:

High School Diploma or equivalent.

• Experience/Lived Experience:
• Experience working with diverse populations displaying respect and sensitivity to diversity, equity and inclusion preferred
• Experience working in a community health setting preferred
• Experience working with complex patient situations a plus
• Special Skills/Training:
• BLS Certification required.
• Strong collaborative skills: ability to effectively and appropriately engage members of the care team, other clinic departments, leadership, and external community partners.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

1. 1. Evaluates social determinants of health, identifies barriers to care and addresses/resolves obstacles impeding progress
2. 2. Processes and closes the loop for community resource referrals
3. 3. Provides warm hand-offs for urgent and stat medical referrals and collaborates with referral coordinators to ensure medical referrals are processed
4. 4. Works with direct supervisor and QI department to ensure quality improvement initiatives are met
5. 5. Meets with each new patient and orients patient and family/caregiver(s) to CommuniCare+OLE
6. 6. As a member of the care team, participates in huddles, team meetings, and case conferencing as needed
7. 7. Educates patient and family/caregiver(s) about relevant community resources
8. 8. Coordinates warm hand-offs for integrated care providers
9. 9. Provides support to primary care providers by completing forms and other tasks as needed
10. 10. Provides care management and creates care plans for patients on high-risk registry.
11. 11. Documents timely and efficiently in the EMR
12. 12. Care manages and documents as per Enhanced Care Management (ECM) processes, a percentage of patients on the high-risk registry determined by the BH Manager, Care Coordination.
13. 13. Covers care coordination duties for colleagues who are out of the office
14. 12. Attends appropriate training courses/webinars and meetings
15. 13. Gathers and reports data related to aspects of care coordination when needed
16. 14. Provides feedback for the improvement of Care Coordination processes