Care Coordinator

The role

The Care Coordinator ensures clinical care for patients through patient service and care coordination across disciplines. You will lead comprehensive care coordination, identify social determinants of health, and assist patients in navigating the healthcare system.

What you will do

• Perform telephonic outreach to enroll and engage patients.
• Develop and implement care plans under the direction of a Nurse Care Manager.
• Facilitate transitions of care across care settings and dialysis centers.
• Conduct patient assessments to identify social, economic, and environmental factors.
• Connect members to resources such as housing, transportation, and food security.
• Guide members in utilizing health and social services.
• Advocate for members by identifying barriers to care.
• Maintain communication with patients, families, and healthcare teams.
• Ensure accurate and timely documentation of interactions and care plans.
• Provide educational resources to patients and families.

Required qualifications

• 3 years of experience in health care coordination, community health work, or similar healthcare related field
• Experience with team-based approach to care
• Excellent working knowledge of community resources
• Exceptional ability to prioritize and task-switch
• Self-directed and motivated to resolve issues professionally and creatively
• Strong communication and teaching skills
• Intermediate skills with MS Office Suite of products including Outlook and Teams
• Minimum download speed of 25 Mbps and upload speed of 10 Mbps
• Ability to work from a dedicated space lacking ongoing interruptions to protect PHI / HIPAA information

Benefits

• Paid time off starting at 4 weeks for full-time employees
• 12 paid holidays per year
• Medical, dental, vision and life insurance
• HSA with employer match
• Reimbursement for continuing medical education for eligible roles
• 401(k) program with up to 4% employer match after six months of tenure
• Paid parental leave
• Training and development program

About the company

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach. They aim to improve patient outcomes and quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants.