Integrated Care Coordinator (ICC)

Essen Health Care; Easton (Northampton County); Hybrid; USD 27,552 - 34,440; Full time

Benefits offered by this job

Remote work options

Hybrid work options

Equal opportunity employer

Job summary

Essen Health Care in New York seeks an Integrated Care Coordinator to serve as a vital link between patients and healthcare services within our multispecialty network. This role focuses on breaking down barriers to care for underserved populations in the Bronx, coordinating between primary care, specialty services, behavioral health, and community resources to deliver comprehensive, patient-centered care.

You will collaborate across Essen's integrated divisions, including urgent care, primary

Qualifications

• High School Diploma required.
• 1-2 years of direct patient care experience.
• Experience in Care Coordination or Case Management.
• Experience with Remote Patient Monitoring.
• Familiarity with Electronic Health Records (EHR).
• Experience in outreach and community engagement.

Responsibilities

• Develop and maintain care plans addressing medical, behavioral, and social determinants of health.
• Coordinate services across integrated clinical divisions including urgent care, primary care, and specialty services.
• Facilitate transitions between telehealth, in-person visits, and home care.
• Utilize Remote Patient Monitoring to track progress and address health concerns.
• Monitor adherence to care plans and adjust interventions as needed.
• Conduct initial assessments to identify patient needs and barriers to care.
• Perform community outreach to engage underserved populations in the Bronx.
• Educate patients and families about health conditions and self-management in English and Spanish.
• Support navigation of community resources and social services in NYC.
• Advocate for patient access to appropriate services.

Skills

Bilingual Spanish & English

Communication skills

Public speaking

Organizational skills

Cultural sensitivity

Motivational interviewing

Education

High School Diploma

Tools

Electronic Health Records (EHR)

Remote Patient Monitoring

Job description

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents.

Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community.

Position Title

Integrated Care Coordinator

Position Summary

The Integrated Care Coordinator serves as a vital link between patients and healthcare services, ensuring seamless coordination across our multispecialty network. This role focuses on breaking down barriers to care for underserved populations in the Bronx, coordinating between primary care, specialty services, behavioral health, and community resources to deliver comprehensive, patient-centered care. This position is ideal for individuals looking to make a meaningful impact in the healthcare field while working in a supportive team environment. You'll be part of an organization that has demonstrated over 25 years of commitment to innovating healthcare delivery for underserved communities, with opportunities to grow alongside our rapidly expanding multispecialty medical group.

Key Responsibilities

• Develop and maintain comprehensive care plans addressing medical, behavioral, and social determinants of health
• Coordinate services across Essen's integrated clinical divisions including urgent care, primary care, and specialty services
• Facilitate smooth transitions between care settings including telehealth, in-person visits, and home care through Essen House Calls
• Utilize Remote Patient Monitoring tools to track patient progress and proactively address health concerns
• Monitor patient adherence to care plans and adjust interventions based on outcomes

Patient Engagement & Outreach

• Conduct initial assessments to identify patient needs, preferences, and barriers to care
• Perform community outreach to engage underserved populations in the Bronx
• Educate patients and families about health conditions, treatment options, and self-management strategies in both English and Spanish
• Support patients in navigating community resources and social services throughout New York City
• Advocate for patients within the healthcare system to ensure access to appropriate service

Experience / Education

• High School Diploma
• 1-2 years of direct patient care experience
• Experience in Care Coordination or Case Management
• Experience with Remote Patient Monitoring
• Familiarity with Electronic Health Records (EHR)
• Previous experience in outreach, community engagement, social services, or related field

Skills & Competencies

• Bilingual Fluent in Spanish and English (Highly preferred)
• Excellent communication and public speaking skills
• Ability to work independently and travel within the Bronx
• Knowledge of community resources and services in New York City
• Strong organizational and time management skills
• Cultural sensitivity and ability to work with diverse, underserved populations
• Proficiency in motivational interviewing and health coaching techniques

Compensation & Benefits

• Pay $20.00 - $25.00 per hour
• Job Type Full-time
• Remote & Hybrid opportunities available
• Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.