Patient Care Coordinator-Temporary – Neighborhood Healthcare
This full‑time, temporary position (anticipated end date March 2026) will assist primary care practice teams to improve patient health outcomes. The coordinator will provide panel management for patients at highest risk for health deterioration, increase access to health services and resources, and support patients in achieving their self‑care goals.
Responsibilities
Utilize the primary care medical home model to provide coordinated team care for current diseases.
Provide panel management for preventative and health‑maintenance follow‑ups for the maximum number of patients per day.
Contact new patients to give a warm welcome, explain the medical home, and answer questions.
Schedule patients with chronic conditions for follow‑up appointments per preventative and maintenance care schedules.
Perform population‑management tasks such as appointment scheduling, recalls, web‑portal callbacks, and telephone encounters.
Make outreach calls to patients missing appointments based on preventative and chronic‑disease guidelines.
Delegate ECW telephone encounters and web‑portal messages to medical assistants and providers.
Implement actions for increasing productivity, such as scheduling same‑day appointments and maintaining full provider schedules.
Track and report progress of assigned tasks and logged PCP discussion topics in weekly supervisor meetings.
Collaborate with PCPs to identify and implement population‑management improvements and better patient‑care outcomes.
Organize weekly pre‑clinic team huddles to discuss progress on goals such as Meaningful Use compliance and C.A.R.E. Transformation.
Coordinate monthly medical‑assistant team meetings to discuss progress toward PCMH goals.
Provide and document patient end‑of‑visit interviews, coaching, and engagement conversations.
Reinforce information given to patients and/or families with handouts to improve self‑management skills.
Provide patient education during medical appointments as needed.
Act as first point of contact for queries through the patient web portal and by phone.
Submit prior authorizations for medications, DME supplies, and other items as needed.
Demonstrate values of Transforming Care, including courteous behavior and a commitment to accuracy.
Collaborate with PCPs for overall patient‑health accountability.
Complete ECW notes for all care‑coordination services in a timely manner.
Prioritize activities according to need and required follow‑up.
Provide accurate and timely reports to the supervisor as required.
Participate in quality‑improvement activities that benefit the organization.
Instill confidence in the care, facilities, and staff for patients and stakeholders.
Assist medical assistants and patients as needed.
Qualifications
Education and Experience
High school diploma or GED required.
Medical Assistant Certificate from an accredited program required.
Valid AHA BLS certification required (on or before hire date).
One year medical‑assistant experience within a medical‑home health preferred.
Non‑profit community health clinic experience preferred.
Bilingual (English/Spanish) highly preferred.
Diabetes and hypertension education experience preferred.
Additional Qualifications (Knowledge, Skills and Abilities)
Excellent verbal and written communication, including superior composition, typing, and proofreading skills.
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form.
Knowledge of and experience with medical‑home health models.
Adaptability to changing patient or organizational priorities.
Ability to manage multiple tasks simultaneously.
Use of critical thinking to make decisions and solve problems.
Excellent planning and organizational ability.
Teamwork and independent work capabilities.
Professional handling of highly confidential information.
Physical Requirements
Ability to lift/carry up to 20 lbs.
Ability to stand for long periods of time.
Pay range: $24.95 to $34.93 per hour, depending on experience.
Compensation Disclosure: The posted salary range reflects the designated pay grade for this position. Actual compensation will be based on several factors, including but not limited to candidate knowledge, skills, experience, market data, benchmarks, internal equity, and organizational needs. Placement within the range is not guaranteed, and the full range may not be utilized.