Chronic Care Coordinator

Phamily-JaanHealth is helping to place a Chronic Care Coordinator for our client in Winter Park, FL. This individual will work internally for our client, Nephrology Associates of Central Florida (NACF), using the Phamily platform. Phamily is a Chronic Care Platform. 

The Chronic Care Navigator is a Certified Medical Assistant who supports the development of patient- centered, team-based care. The Navigator will support the Nephrologists and Nephrology Associates of Central Florida in managing their panel of patients using the Phamily platform. By gathering and organizing patient data, the Chronic Care Navigator works to identify patients unmet needs, engage patients in their own care, gather summary information for treatment interventions, and enhance ongoing communication between the patient and her/his care team.The goal of the Chronic Care Management program is to facilitate high-value, patient-centered care that improves timely access to and provision of preventive services and chronic disease treatment.

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Medical Specialty:

• Primary Care

Schedule:

• M-F 8am - 5pm

Work Location: On Site in Winter Park, FL

● Develop a keen understanding of primary care practice requirements for optimal, coordinated population health

● Work as an effective team member of the care team

● Collaborate with care teams to establish population-appropriate, pre-visit, and point of care processes

● Work with the Phamily Chronic Care Management platform to support patients with multiple chronic diseases and assists in coordination of the patients care continuum.

● Contribute to quality improvement and care redesign of population health efforts

● Manage patient registries

● provide the members of health care teams in designated practices with the data required to meet the health needs of the patient

● Support practice staff to develop interventions to proactively manage target populations

● Contribute to a positive experience for patients and families through courteous telephone and digital interactions, accurate and expeditious routing, as well as referral to appropriate clinical staff when necessary

● Recognize and report data inconsistencies to appropriate personnel

● Contribute to the teamwork within and between departments.

● Regularly attend and participate in meetings with coworkers and practice staff.

● Perform all job functions in compliance with applicable federal, state, local and company policies and procedures

● Provide data to the care teams to properly perform these processes

● Monitor and correct patient attribution to the practice and the care teams within the practice

● Other duties as assigned

● Proven problem-solver with ability to multitask.

● Excellent communication skills, both written and spoken.

● Bilingual in English and Spanish preferred.

● Prior use of EHR/EMR systems highly desirable.

● Medical Assistant Certification preferred.

● Nephrology experience beneficial.

 Benefits

• 401(K)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Note: Phamily screens candidates, but the client’s hiring team makes the final hiring decision.

Apply today to make a difference in chronic care management.