Care Management Coordinator

Northwell Health; Melville (NY); On-site; USD 55,000 - 85,000; Full time

Job summary

Northwell Health in New York seeks a Care Management professional to coordinate services for families and caregivers, using patient-centered approaches to improve health outcomes. You will support the primary care team with panel management and develop individualized care plans for high-risk patients.

As a liaison among hospitals, primary care providers, specialists, and community resources, you will drive outreach across sites, homes, and neighborhoods to ensure timely follow-up and access to

Qualifications

• High School Diploma or equivalent required.
• 1-3 years of relevant experience, required.
• Bachelor's or Master's degree in relevant field strongly preferred.
• Health home or care management experience strongly preferred.
• NYS Driver's License strongly preferred.
• Bilingual Spanish, preferred.

Responsibilities

• Coordinates and participates in care management activities for families and caregivers.
• Utilizes patient-centered motivational interviewing to build rapport and improve health.
• Supports care team with panel management to reduce care gaps and non-adherence.
• Acts as liaison among hospitals, primary care providers, specialists, and community resources.
• Identifies high-risk patients and tracks preventive or chronic care needs.
• Performs outreach across sites, homes, hospitals, and neighborhoods to close care gaps.

Skills

Motivational interviewing

Care coordination

Team-based communication

Patient-centered care

Education

High School Diploma or equivalent

Bachelor's degree (preferred)

Master's degree (preferred)

Tools

EHR/EMR

Job description

Job Description

Coordinates and participates in activities related to Care Management services to family members and caregivers.

Job Responsibility

• Utilizes patient-centered motivational interviewing techniques to build rapport and help patients improve their health.
• Supports the primary care team by providing panel management to decrease the number of patients lost to care, non-compliant in follow up care or disconnected from primary care. Participates in the development, maintenance, and adjustment of individualized care plans for high-risk patients that address both medical and social barriers to accessing care.
• Acts as a professional liaison between hospitals, primary care providers, specialists, and community resources on behalf of patients to ensure patient-centered care coordination.
• Identifies and tracks special populations, including high-risk patients and other populations due for preventive or chronic care services.
• Identifies and tracks patients discharged from the inpatient service or the emergency department.
• Uses team-based communication strategies to close the loop on referrals, hospital follow-ups and any outstanding items identified in the patient's care plan. Performs outreach activities in primary care sites, homes, hospitals, and neighborhoods.

Job Qualification

• High School Diploma or equivalent required.
• 1-3 years of relevant experience, required.
• Bachelor's or Master's degree in relevant field strongly preferred.
• Health home or care management experience strongly preferred.
• NYS Driver's License strongly preferred.
• Bilingual Spanish, preferred.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).