Patient Care Coordinator - LPN
Jane Pauley is a multifunctional Federally Qualified Healthcare Center (FQHC), specializing in providing stable consistent healthcare to all individuals in need regardless of income or insurance status. We are an ever-growing innovative organization with 20+ facilities in 5 counties spanning across the greater Indiana area. We do what we do simply because we care for our communities.
For more information, or to submit an application, please visit us at: https://janepauleychc.org/careers/
Patient Care Coordinator is an essential member of the practice care team at The Jane Pauley Community Health Center (JPCHC). Under the direction of the Practice Manager, the Patient Care Coordinator supports the promotion of health, disease prevention and management, teaching and education, developing nursing care plans, and communicating with external facilities and patient's families. Works hand in hand with all members of the healthcare team to achieve quality outcomes for the population of the practice site.
Summary of Essential Job Functions/Responsibilities
- Assists patients through the healthcare system by acting as a patient advocate.
- Facilitates and provides health patient education utilizing evidence-based practice, JPCHC approved patient handouts and assessment of patients or families teach back skills.
- Facilitates patient self-care management of disease and behavior modification interventions.
- Coordinates continuity of patient care internal to JPCHC and between internal teams and external healthcare facilities including referrals from the primary care to a specialty care entity.
- Coordinates continuity of patient care with patients and families following hospital admission, discharge and ER visits through telephonic outreach and use of health information exchange.
- Collaborate with the Care Team for smooth transition of care for patients referred to JPCHC providers.
- Coordinates continuity of patient care for assigned high risk patient populations and facilitates scheduling of follow-up appointment based on internal provider’s plan of care.
- Performs phone triage within the scope of his/her of training and license and utilize age-appropriate clinical assessment and intervention with patients to support their psycho-social, and medical needs, provides recommendation to patients or families based on JPCHC triage protocol and/or as recommended by medical providers.
- Serves as point of contact for walk-in patients for appropriate care.
- Performs medication refills and prior authorization.
- Documents timely, consistently, and thoroughly of patients’ face to face encounters or phone interactions and contacts attempts in the EMR utilizing standard nursing process.
- Participates in clinical quality improvement initiatives and provides recommendation on clinical best practice.
- Provides feedback to JPCHC QI Committee on the quality and effectiveness of quality metrics tools.
- Works closely with providers and clinical staff of pre-visit planning activities.
- Monitors closure of care gaps and quality metrics and provide recommendations on clinical best practice.
- Performs proactive outreach of patients due for preventive screenings.
- Monitors overdue lab results and notifies medical providers of abnormal findings or critical values.
- Participates on a team for data collection, health outcomes reporting, clinical audits, and programmatic evaluation related to the Patient-Centered Medical Home and Medical Neighborhood initiatives.
- Participates in precepting newly hired clinical staff or nursing students.
- Graduation from accredited Nursing Program.
- Current state licensure as a Licensed Practical Nurse.
- Two years’ experience as a triage, or in ambulatory, insurance, or acute care setting preferred.
- 2-5 years’ experience in chronic disease management, case management, utilization management, and adult acute care preferred
- 1 year in a Patient-Centered Medical Home clinical setting or knowledge of the Patient-Centered Medical Home initiative preferred
- Basic Life Support through AHA required
Benefits package includes medical; dental; vision; life; voluntary life; long-term disability; short-term disability; flexible spending accounts; generous paid time off; generous company match 401(k) retirement plan; tuition reimbursement; EAP and much more!
Come join an organization that cares.For more information, or to submit an application, please visit us at: https://janepauleychc.org/careers/