Coordinator - The Longstreet Clinic - Population Health

About the role

The Population Health Coordinator is responsible for developing and monitoring care coordination processes and providing support to the population health team for implementing these processes. This role serves as a support role to the Care Managers and acts as a liaison between patients, their families, and the healthcare delivery team, including inpatient facilities, emergency departments, and ancillary services.

Responsibilities

• Reach out and engage patients to facilitate care delivery coordination, care gaps, and care needs; maintain a daily call schedule.
• Outreach to low-risk patients during care transitions.
• Serve as a liaison between the patient, their family, and their Longstreet Clinic care team.
• Absorb and manage data for target patient populations and assist in patient outreach.
• Work with Care Managers on quality improvement initiatives and meeting requirements for achieving/maintaining NCQA practice and provider recognitions.
• Report to the Population Health Manager on productivity goals and performance.
• Participate in the development/review/revision of standard work and related policies and/or procedures for Care Manager services.
• Attend and participate in regular meetings with the Population Health Team and other departments (Clinical and Non-Clinical) and practices as needed.
• Participate in required offsite health fairs and other community events as assigned.

Qualifications

• Licensure or certification: Certified Medical Assistant (or 5 years of direct population health experience in lieu of CMA).
• Educational requirement: High School Diploma or GED.
• Experience: Minimum 5 years of direct population health experience.