Care Coordinator - Napa

CommuniCare+OLE; Napa (CA); Vor Ort; USD 40.000 - 50.000; Vollzeit

Benefits dieser Stelle

PTO 18 days (Vacation & Sick)

Holidays

403(b) retirement plan

Tuition reimbursement

Life insurance

Health Savings Account

Zusammenfassung

OLE Health is seeking a Care Coordinator to work closely with patients, families, and care teams to optimize health outcomes through effective care navigation and resource linkage.

The role focuses on addressing social determinants of health, coordinating referrals, and supporting high-risk patients within a collaborative, multi-disciplinary environment.

Qualifikationen

• BLS certification is required.
• Strong collaborative skills to engage the care team and partners.
• Education: high school diploma or equivalent.

Aufgaben

• Evaluate social determinants of health and identify barriers to care.
• Close the loop on community resource referrals.
• Provide warm hand-offs for urgent referrals and coordinate with referral teams.
• Support quality improvement initiatives with the supervisor and QA.
• Meet new patients and orient them and their families to OLE Health.
• Participate in huddles and team meetings as part of the care team.
• Educate patients and families about community resources.
• Coordinate warm hand-offs for integrated care providers.
• Assist primary care providers by completing forms and tasks as needed.
• Care management and care plans for high-risk patients.
• Document timely in the EMR and maintain patient records.
• Contribute to ECM processes for high-risk registry patients.
• Gather and report data related to care coordination tasks.
• Provide feedback to improve Care Coordination processes.

Kenntnisse

BLS Certification

Collaboration

Ausbildung

High School Diploma or equivalent

Jobbeschreibung

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.

Salary Range: $29.32 To $35.83 Hourly

Care Coordination

BH Manager, Care Coordination

SUPERVISORY RESPONSIBILITIES (does this position have direct reports):

NO

About OLE Health

OLE Health 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, OLE Health 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

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

OLE Health 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.

Evaluates social determinants of health, identifies barriers to care and addresses/resolves obstacles impeding progress

2.

Processes and closes the loop for community resource referrals

3.

Provides warm hand-offs for urgent and stat medical referrals and collaborates with referral coordinators to ensure medical referrals are processed

4.

Works with direct supervisor and QI department to ensure quality improvement initiatives are met

5.

Meets with each new patient and orients patient and family/caregiver(s) to OLE Health

6.

As a member of the care team, participates in huddles, team meetings, and case conferencing as needed

7.

Educates patient and family/caregiver(s) about relevant community resources

8.

Coordinates warm hand-offs for integrated care providers

9.

Provides support to primary care providers by completing forms and other tasks as needed

10.

Provides care management and creates care plans for patients on high-risk registry.

11.

Documents timely and efficiently in the EMR

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.

Gathers and reports data related to aspects of care coordination when needed

14.

Provides feedback for the improvement of Care Coordination processes