Job Description

Patient Care Coordinator manages and coordinates all aspects of a patient’s care, working closely with the care team to ensure treatment plans are followed and the patient’s needs are met. Assists the care team in coordinating safe, timely, effective, efficient, equitable, patient-centered care. Assesses self-management skills of patients and caregivers and encourages wellness and autonomy through support, training and coordination of community and/or referred services. Communicates regularly with patients and caregivers regarding Plan of Care (POC). Responsible for management and coordination of internal and external referrals. Acts as a communication portal between patients and their care team, sharing lab results to patients, generates patient letters, and completes relevant forms as needed. Performs patient outreach- either by telephone or text encouraging patients to schedule with care team. Supports care coordination within and outside of the SEARHC health system to ensure a consistent, effective, supportive system of care. Facilitates efficient clinic flow and utilization. Tracks and maintains case management and coordination data. Monitors normal patient progress and tracks outcomes using SEARHC standards of performance and care. Advocates for patient and patient caregivers at service-delivery level, empower patient decision-making and self-care, and addresses patient needs in a timely manner. Facilitates patient outreach utilizing patient health and quality data. Participates in departmental and clinical improvement efforts, maintains a clean and safe working environment for self, staff, and patients, and maintains compliance with annual competencies. Identifies community resources, fosters partnerships, and utilizes resources effectively. 50 % of the job will require referral management work, 25% performing patient outreach and 25% care team communication. Other duties as assigned. Education, Certifications, and Licenses Required: Associate’s degree or 2 years of college preferably in social work, social services, healthcare administration, business administration, or related field OR 2 years of relevant professional experience may be exchanged for a degree or course work. A Bachelor’s degree in a relevant field may be exchanged for all required experience. Basic Life Support preferred. Experience Required: 2 years of healthcare, behavioral health, dental, or relevant administrative experience required. Internal candidates with at least 2 years of experience working in a front or back-office role may be considered for this role. Knowledge, Skills, and Abilities: Knowledge of available services at SEARHC, other tribal health organizations in Alaska, and community. The clinical process and the ability to apply this knowledge in the working environment. Customer service principles. Safety and infection control principles. Skills in assessment, anticipation of needs, and data collection. The use of equipment such as computers and medical equipment. Oral and written communications. Ability to work in teams- Providers, Nurses and other healthcare personnel. Computer Skills: Proficient in Microsoft Office Products including Word, Excel, and PowerPoint. Other Qualifications: Excellent communication and interpersonal skills, strong organizational & time management abilities, teamwork, proficient in EHR systems. Travel Required: Travel not required. Safety and Risk Management Responsibilities: Employees are responsible for complying with safe work rules; reporting all accidents and injuries immediately; cooperating in all accident and injury investigations; reporting defective equipment and unsafe conditions. Physical Demands: While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; sit; use hands to finger, handle or feel and reach with hands and arms. The employee is occasionally required to climb or balance; stoop, kneel, crouch or crawl. The employee must lift and/or move 50 lbs. Work Environment: The noise level in the work environment is usually moderate.

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