About Our Company

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

Job Description

Note: This role will be based in Overlook Medical Center in Summit NJ

Role: Full time

Hours: 8:30am - 5pm

Essential Job functions:  

· Engage patients and their support systems at the bedside, reviewing reason for admission and the current treatment and discharge plan.

· Collaborate with inpatient care team/hospitalist to ensure patient is receiving well-coordinated care and collaborate with care management team to ensure potential risk factors are mitigated prior to discharge, reducing the risk of readmission.

·  Share and educate patient and caregivers on preferred facilities should post acute care be warranted. 

·  Promote advance care planning and navigate patient through process to outline their healthcare wishes.

·  Serve as a liaison between the inpatient, outpatient and care management teams to ensure continuity of care and coordination of services.  

·  Schedule post discharge follow up appointments with the PCP and SH specialist at bedside. 

·  Communicate patient’s admission, progression and discharge plans to the care management team.  

·  Educate patients on the TCM process for seamless transition from hospital to home. 

·  Serve as a contact point, advocate and informational resource for patients, care teams  and family/ caregivers.

·  Place referrals to pertinent care management team members based on patient needs

·  Documents appropriately in the electronic health record and any required patient tracking documents.  Employs appropriate and timely use of tasking in the EHR.  Maintains accurate and timely documentation. Ensures documentation meets current standards and policies. 

· Performs all care manager activities across the continuum of care while adhering to the core values of patient confidentiality, privacy, safety, advocacy, and adhering to ethical, legal, and accreditation/regulatory standards. 

·  Ability to manage conflict, stress and multiple simultaneous work demands in an effective and professional manner.