Care Specialist

About the role

The Care Specialist is a key member of the team responsible for delivering chronic care management to high-complexity patients. The primary focus is on direct outreach to patients, guiding them through the enrollment process, facilitating virtual appointments with providers, and ensuring patients adhere to care plans.

Responsibilities

• Direct outreach to patients, engaging in both in-home and virtual care settings.
• Facilitating virtual appointments with healthcare providers.
• Ensuring patients adhere to care plans by building relationships and coordinating care.
• Providing education to patients to promote health, prevent unnecessary hospitalizations, and improve patient outcomes.

Requirements

• Minimum of 2 years of relevant work experience (e.g., Community Health Worker, Peer Support Specialist, Medical Assistant, etc.).
• A high school diploma or GED.
• A valid driver's license, auto liability insurance, and reliable transportation to travel within the assigned territory.
• Experience in chronic care management or working with chronically ill/elderly patients.
• Technologically proficient with basic computer skills (typing, using EMR systems).
• Experience with motivational interviewing, trauma-informed care, and care coordination.
• Strong interpersonal communication skills with the ability to engage patients and team members effectively.
• Ability to prioritize tasks, manage schedules, and work independently in an unstructured environment.
• Multi-lingual skills are a plus but not required.
• Prior home care experience is beneficial.

Qualifications

• Adaptability & Resilience: Ability to thrive in unstructured environments and pivot as needed to meet patient needs.
• Self-Starter & Motivation: Proactively takes initiative in managing patient care and outreach.
• Empathy & Compassion: Ability to work with individuals from diverse backgrounds and understand their complex needs.
• Accountability & Integrity: Demonstrates personal responsibility and takes ownership of tasks, ensuring accuracy and timeliness in all activities.
• Cultural Competence: Awareness of community dynamics and diversity, ensuring culturally sensitive and inclusive care.
• Team Collaboration: Works collaboratively with interdisciplinary teams to meet patient and organizational goals.
• Problem-Solving & Critical Thinking: Strong critical thinking skills to assess patient needs, analyze data, and develop appropriate care strategies.
• Communication Skills: Excellent verbal and written communication, capable of explaining complex medical information to patients in a clear and supportive manner.
• Care Coordination: Ability to engage patients in a comprehensive care plan, facilitating communication between patients, providers, and family members to ensure timely, effective care.
• Health Education: Effectively educates patients about their medical conditions, care plans, and available resources, ensuring that patients can make informed decisions.
• Patient Engagement: Uses various strategies, including phone calls, home visits, and community outreach, to engage patients and ensure continuous participation in their care.
• Time Management & Organization: Demonstrates strong organizational skills by managing patient caseloads, schedules, and documentation efficiently.
• Technology Proficiency: Skilled in using electronic health records (EMR) systems and other digital tools to document patient information and communicate within the team.
• Motivational Interviewing & Patient-Centered Care: Uses motivational interviewing techniques to build rapport and empower patients to take ownership of their health decisions.
• Data Management: Ensures accurate and timely documentation of patient data, ensuring continuity of care and compliance with organizational standards.
• Outcome-Oriented Approach: Focuses on achieving key health outcomes, such as improved care adherence, reduction in emergency room visits, and enhanced self-management.

Skills

• Adaptability & Resilience
• Self-Starter & Motivation
• Empathy & Compassion
• Accountability & Integrity
• Cultural Competence
• Team Collaboration
• Problem-Solving & Critical Thinking
• Communication Skills
• Care Coordination
• Health Education
• Patient Engagement
• Time Management & Organization
• Technology Proficiency
• Motivational Interviewing & Patient-Centered Care
• Data Management
• Outcome-Oriented Approach

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