Value-Based Care Care Navigator

LSU Plastic Surgery; New Orleans (LA); On-site; Full time

Job description

SUMMARY

The LSU Healthcare Network is a non‑profit, academic, multi‑specialty healthcare delivery system dedicated to patient care, research, and education. You can be a part of a progressive healthcare team making a meaningful difference in the care of patients. The LSU Healthcare Network is made up of over 175 healthcare providers – from primary care to specialty care – at several multi‑specialty care locations in and around the Greater New Orleans area.

We offer a competitive compensation and benefits package, including:

• 15 PTO Days
• 11 Paid Holidays
• 401(k) Plan with employer match
• Health Insurance
• Tuition Reimbursement

Position Purpose

The Care Coordinator is responsible for ensuring each patient’s experience with the LSU Healthcare Network is seamless, coordinated, and comprehensive. This role reviews, plans, and coordinates healthcare services using evidence‑based guidelines and value‑based care strategies to improve clinical outcomes, reduce healthcare costs, and optimize resource utilization.

The Care Coordinator applies clinical knowledge and population health tools to conduct ongoing patient assessments, identify and close gaps in care, facilitate referrals, screenings, and diagnostic testing, and provide patient education. The role ensures timely follow‑up and effective use of appropriate resources to improve patient health outcomes and overall quality of care. The Care Coordinator also collaborates closely with physicians and insurance payers to align quality initiatives and promote coordinated, cost‑effective care.

Principal Responsibilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Utilize population health management tools to improve quality outcomes and reduce healthcare costs across all value‑based contracts
• Develop and implement care management protocols and workflows aligned with evidence‑based guidelines and organizational best practices to enhance patient care
• Engage, educate, and support physicians and clinical staff in quality improvement initiatives and performance on HEDIS measures
• Assist in the organization’s participation in the CMS Quality Payment Program (QPP), supporting more than 800 physicians statewide
• Assist the Director of Quality by providing and distributing monthly reports on patient outreach and quality metrics
• Collaborate with insurance payers to build cohesive working relationships that support quality initiatives and coordinated, cost‑effective care
• Guide patients throughout their healthcare journey—from initial outreach through referral completion, missed appointment follow‑up, and care gap closure
• Assist patients with scheduling appointments for office visits, diagnostic testing, treatments, procedures, and follow‑up care
• Ensure results of testing, treatments, and procedures are received, reviewed, and accurately documented in the patient’s medical record in a timely manner
• Actively follow up on patient concerns or care coordination issues until resolution, and communicate outcomes to both the patient and their care team
• Review HEDIS, Star, and Risk Adjustment reports at least monthly with the Director of Quality to develop action plans that improve measure performance and patient outcomes
• Perform other job‑related duties as assigned

Core Competencies

• Professionalism
• Strong verbal and written communication skills
• Planning and organizational skills
• Highly developed sense of integrity and commitment to customer satisfaction
• Conflict management and resolution
• Manages time appropriately/efficiently/effectively
• Excellence in interpersonal relations
• Ability to work independently and proactively, and make decisions
• Ability to handle multiple demands of a diverse workload and prioritize critical issues
• Ability to effectively interact with multifaceted providers, medical professional staff, and insurance payers

Requirements

Experience/Education

• High school diploma or GED equivalent required
• LA LPN license or Medical Assistant Certificate preferred
• Minimum 2 years clinical experience in a patient care environment in a clinical or similar setting required
• Experience in Value‑Based Care preferred
• Knowledgeable and experienced in computer skills, particularly Microsoft Office products and Electronic Health Records

Physical Demands/Working Conditions

• Must be able to lift 10‑15 pounds and operate standard office equipment, computer, printer, fax, and copier
• Ability to travel between various clinics and hospitals
• Must be available to work extended hours, overtime, and non‑traditional hours as needed