Integrated Care Coordinator — Patient-Centric & Transitions

Legacy Health; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Legacy Health is seeking a skilled care coordinator to facilitate interdisciplinary, patient-centered, high-quality care across acute and chronic conditions. You will ensure smooth transitions, partner with patients and families, and support evidence-based practice.

The role emphasizes collaboration with clinical teams, efficient resource use, and adherence to standards of care, with focus on care transitions and timely communication across care settings.

Responsibilities

• Coordinates interdisciplinary provision of comprehensive, patient-centered, quality health care across the continuum for patients with acute and chronic conditions.
• Fosters achievement of optimal outcomes within accepted standards of care.
• Acts as expert resource to the healthcare team regarding the continuum of care, efficient use of resources, Best Practice protocols, and regulatory requirements.
• Ensures smooth transition of care between multiple health care environments with planned handoffs.
• Partners with patients and families to identify health care issues and barriers to self-care, set priorities, and plan interventions.
• Demonstrates cultural agility and applies health literacy guidelines to educate on self-management strategies.
• Uses rapid quality improvement cycles to monitor, evaluate, and report progress of interventions and outcomes.
• Paces the case to assure fiscally sound care coordination across the continuum.

Job description

Legacy Health is seeking a skilled care coordinator to facilitate interdisciplinary, patient-centered, high-quality care across acute and chronic conditions. You will ensure smooth transitions, partner with patients and families, and support evidence-based practice.

The role emphasizes collaboration with clinical teams, efficient resource use, and adherence to standards of care, with focus on care transitions and timely communication across care settings.