Care Coordination Outreach Worker

Aunt Martha’s Health and Wellness boldly commits to supporting the well-being of our communities, ensuring equity in access and delivering exceptional care inspired by a culture of innovation. We are taking a responsible approach to creating environments that allow us to do what we do best—provide healthcare and wellness. As a part of our commitment to health and safety, COVID-19 vaccines are required for all employees, as well as all newly hired employees. We require documentation upon hire.

SUMMARY

Under the direct supervision of the Care Coordination Outreach Supervisor, the Care Coordination Outreach Worker performs general functions include facilitating the appropriate delivery of healthcare services for patients within the Aunt Martha’s Health and Wellness. The Care Coordination Outreach staff complete health risk assessments for patients assigned to the network as well as schedule appointments for patients recently released from the hospital emergency department or patients recently discharged from inpatient care. The Care Coordination Outreach Worker provides excellent quality care, positive customer service, the maintenance of an efficient and safe environment of care. Demonstrates superior customer service skills and has the ability to function in a multi-tasking, multiple priorities environment, while maintaining accuracy and attention to detail.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Maintain patient confidentiality at all times per the policies and procedures.
• Maintain ethical behavior at all time per the policies and procedures.
• Responds to internal and external customer needs in a positive manner, utilizing principles of the AIDET model; exceeding their needs and expectations and providing the highest quality service to ensure the best possible outcomes.
• Master the electronic health record system, Athena, to appropriately document patient data and information, in addition to managing databases with outcomes data.
• Complete health risk screenings on all active care coordinated patients.
• Complete outreach services on active care coordinated patients through clinic visits, home visits or hospital visits.
• Provide ongoing health education for all patients directly related to appropriate ED utilization and preventative services.
• Answers designated telephone calls in a courteous manner, appropriately routes communication, responds to inquiries and transcribes messages.
• Collaborate with health plans, specialists, hospitals, and physicians to ensure complete and total patient care.
• Attend all trainings and meetings as required by the program.
• Complete all Core Curriculum training(s) required for this position.
• Perform all other duties as assigned.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

EDUCATION and/or EXPERIENCE

• High School Diploma or Equivalent required
• Experience in working with Microsoft Office programs essential; adept at data entry.

OTHER QUALIFICATIONS

Current driver’s license

Current auto insurance

Ability to work late evening hours, weekend hours, and scheduled holidays, as needed

Aunt Martha’s is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.