Job Summary:

WELLBE INTRODUCTION

The WellBe care model is a Physician Led Advanced Geriatric Care Program focused on the quality of care of the frail, poly-chronic, and elderly Medicare Advantage patients. This population is typically underserved and very challenged with access to overall health care. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. WellBes Care Model is to provide our members the entire continuum of care from chronic to urgent care in the home, hospital, skilled nursing facility, assisted living, palliative care, and to end of life care. WellBe's physician/advanced practicing clinician led geriatric care teams partner with the patients primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.

GENERAL SUMMARY

Our Patient Care Coordinator (PCCs) are part of a home-based care team that provides compassionate care to the frail population who suffer from chronic and acute illnesses or injuries. Our PCC is responsible for answering incoming and outgoing calls, coordinating care with the rest of the medical team, scheduling patient appointments, specialist appointments and coordinating diagnostic tests, being a community resource, working to engage patients that currently are not engaged, and contributing complete and accurate data in patient's records. The successful candidate will employ critical thinking and decision making, be comfortable with technology, have flexibility, and love working with patients and a collaborative interdisciplinary team. We offer a positive, upbeat work environment where all medical personnel work together for the good of the patient.

SKILLS & COMPETENCIES

• Practice the WellBe mission: To help our patients lead healthier, meaningful lives by delivering the most Complete Care.
• Remote Telephonic Triage
  • Perform thorough telephone-based medical triage to evaluate patients' concerns and prioritize cases based on urgency and direct patients to the appropriate to the on-call provider.
• Communication and Collaboration
  • Collaborate effectively with on-call physicians, nurse practitioner, and other healthcare staff to ensure seamless patient care.
• Updates and maintains all digital client records and assists in transitioning hard copy records to digital format.
• Acts as a community resource for the patient.
• Conduct patient scheduling, registration, and eligibility verification
• Manage patient medical records as appropriate.
• Answer phone calls and emails from patients, make outcoming calls, prioritize patient concerns as appropriate.
• Answer patient non-clinical questions and explain the process.
• Schedules/coordinates WellBe provider visits with patients, tests, specialist appoints, social resources.
• Ensure all appropriate patient information is in the EMR.
• Provide positive customer service and treat all patients and staff with respect.
• Prioritizes urgent patient needs, scheduling needs for Complete Care Assessment, and efforts to engage the unengaged
• Collaborates with the interdisciplinary team and participates in regularly scheduled team meetings.
• Support APC in ongoing panel management and quality of care efforts (e.g., HEDIS)
• Completes next day visit chart prep.
• Utilize reporting to help providers track, meet and exceed team goal,
• Other tasks needed to accomplish teams objectives/goals.

Job Requirements

Educational/ Experience Requirements :

• High school graduate or GED

License, Certification, Registration

• MA Certification-Preferred

Required Skills and Abilities:

• 2+ years of experience working for a healthcare practice or hospital
• High level of professionalism
• Ability to effectively communicate with older adults, including understanding their unique communication needs, addressing cognitive impairments or sensory deficits, and using age-appropriate language and explanations.
• EMR documentation experience preferred.
  • Proficiency in using EMR software allows for efficient and accurate documentation of patient information, treatment plans, and medical histories.
• High level of professionalism
  • Adhering to ethical standards, maintaining patient confidentiality, and demonstrating integrity in their interactions with colleagues, patients, and their families.
• Strong customer centric focus/service skills
  • The candidate should possess exceptional customer service skills with a focus on patient experience. They should be empathetic, compassionate, and able to effectively communicate with patients and their families.

Supervisory Responsibility : N/A

Travel requirements : Travel may be required up to 25% locally.

Work Conditions: Ability to lift up to 20lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assist with weights of more than 100lbs. Ability to stand for extended periods. Ability to drive to patient locations (ie. home, hospital, SNF, etc). Fine motor skills/Visual acuity

The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.