Overview The Opportunity
As part of The Integrated Care Management Program (iCMP), you will support and coordinate health care for primary care patients with complex health issues. Our team\'s guiding principles are to:
Keep patients healthy and at home as long as possible
Better understand our patients\' health needs to guide timely and effective care
Use performance and benchmark data to identify and act on opportunities for improvement
Strengthen our performance in risk contracts so we can reinvest in our patients by partnering with providers across our hospitals and clinics to develop impactful interventions
The Complex Care Coordinator is vital to the multi-disciplinary team of clinicians serving MGB\'s highest risk patients. The Complex Care Coordinator will coordinate all non-clinical patient needs, help with the connection to the primary care offices and support the patients to achieve their care goals by helping them connect to community resources and services, address social barriers and support patients through reminders and education reinforcement. Responsible for working closely with patients, families, and healthcare providers to ensure a seamless and patient-centered care experience. Assist with navigating the complexities of the healthcare system, coordinating resources, and providing support to improve patient outcomes.
What You\'ll Do Advocate for patients and their families, ensuring their needs and preferences are considered in the care planning process.
Serve as a liaison between patients, healthcare providers, and other relevant stakeholders.
Collaborate with the interdisciplinary healthcare team to coordinate patient care services, appointments, and follow-up plans.
Assist patients in understanding and adhering to their care plans.
Identify and connect patients with appropriate healthcare and community resources, such as support groups, financial assistance programs, and transportation services.
Educate patients and their families about their medical conditions, treatment options, and self-care strategies.
Ensure that patients are informed and empowered to actively participate in their healthcare decisions.
Maintain accurate and detailed documentation of patient interactions, care plans, and resource referrals
What You\'ll Bring Bachelor\'s Degree in a health-related field, public health, or human services field required.
Minimum one year experience in care coordination, population health, or a related healthcare role. Internship or other transferable experience will be accepted.
Experience in navigating healthcare systems, patient advocacy, and understanding of medical/social services.
Bilingual Spanish / English highly preferred
Skills & Abilities for Success Experience documenting in Electronic Health Records, scheduling platforms, and data tracking tools.
Prior experience in managed care, care management, or hospital-based care coordination.
Bilingual or multilingual ability is a plus, especially in languages relevant to the patient population such as Spanish, Portuguese, and Haitian-Creole.
Excellent communication and interpersonal skills.
Ability to collaborate effectively with healthcare professionals across multiple disciplines and experiences.
Exceptional organizational and time management skills.
Exceptional ability to work autonomously while supporting a multidisciplinary team.
What You\'ll Get Great benefits and retirement plans
Experience navigating a large healthcare system as a liaison to patients
Valuable connections in your assigned region
Experience in a fast paced, mission driven organization where the patient comes first
Cross collaboration with MGB colleagues, RNs and patient care team
Onsite Flexible Hybrid Working Model Coordinators will be assigned multiple sites within one region, based on business needs, geographic preference and current home address
M-F Eastern Business Hours
Onsite weekly travel includes Somerville / Community practices within region you are assigned; North, South, East or West
Up to 5 days onsite weekly at various locations, community practices, must be flexible within assigned region and patient needs, typically 1 day remote work per week
Monthly meetings onsite in Somerville, scheduled with notice
Must be open to Somerville and assigned Primary Care sites, local to assigned region for weekly onsite commuting needs
Remote work requires stable, secure, quiet, HIPPA compliant working station
South
Bilingual Spanish / English highly preferred for Jamaica Plain, MA
Bellingham, MA
Boston, MA
Brookline, MA
Foxboro, MA
Franklin, MA
Medfield, MA
Medway
Medway, MA
Mendon
Milford
Milton
Nantucket
Oak Bluffs, MA
Pembroke, MA
Scituate
West Roxbury
Westwood
Weymouth/Pembroke
West
Most needed Natick, Millis/ Walpole, Concord/Sudbury, Wellesley
Andover, MA
Bedford, MA
Belchertown, MA
Burlington, MA
Concord, MA*
Deerfield, MA
Easthampton, MA
Framingham, MA
Greenfield
Groton
Hadley
Hopkinton, MA
Hudson
Lexington
Marlborough
Maynard
Milford, MA*
Millis, MA*
Natick, MA
Norwood
Needham
Newton*
Northampton
Northborough
Northbridge
Amherst
Oxbow
Southboro
Southborough
Sudbury*
Waltham, MA
Walpole, MA*
Watertown, MA
Wellesley, MA*
West Roxbury, MA
Westboro, MA
Westford, MA
Weston, MA
Williamsburg, MA
East
Boston, MA
Charlestown, MA
Chelsea, MA
Chestnut Hill
Everett, MA
Medford, MA
Revere, MA
Somerville, MA
North
Most urgent Needs: Merrimack Valley and Marblehead, MA and Swampscott, MA
Marblehead, MA and Swampscott, MA*
Merrimack Valley*
Beverly, MA
Danvers, MA
Lynn, MA
Newburyport, MA/ Peabody, MA
Haverhill/Lawrence, MA
Rowley, MA
Salem, MA
Saugus, MA
* Most urgent business need
North Region includes:
WDPC, Wentworth Health Partners Barrington Health Center
WDPC, Wentworth Health Partners Bellamy Health Center
WDPC, Wentworth Health Partners Dover Family Practice
Wentworth Health Partners Internal Medicine
WDPC, Wentworth Health Partners Durham Health Center
WDPC, Wentworth Health Partners Hilltop Family Practice
Wentworth Health Partners Primary Care - Pease
Mass General Brigham Integrated Care - Salem
WDPC, Wentworth Health Partners Lee Family Practice
Wentworth Health Partners Adult & Children\'s Medicine
WHP Rochester Family Practice
Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.