Chronic Care Coordinator

Phamily is helping to place a Chronic Care Coordinator for our client in Thomasville, GA. This individual will be working internally for our client Georgia Kidney & Hypertension Clinic, and using the Phamily platform. Phamily is a Chronic Care Platform; more information about the Care Management program can be found here: Phamily CCM Platform

The Chronic Care Coordinator is a Certified Medical Assistant who supports the development of patient-centered, team-based care. S/he will provide support to nephrologists and advanced practitioners in the delivery of care to patients with Chronic Kidney Disease (CKD) by managing their panel of chronic care patients using the Phamily platform.

The goal of the Chronic Care Coordinator is to facilitate high-value, patient-centered care that improves timely access to and provision of preventive services and chronic disease treatment. You will be bridging the communication gap between Nephrologists and their patients to prevent unnecessary hospitalizations and improve overall health.

Disclaimer: While the Phamily team initially screens each role, the ultimate hiring and hiring decisions will be made by the client’s hiring team.

Essential Duties and Responsibilities

• Work with the Phamily Chronic Care platform to support patients with chronic disease and assists in coordination of the patient’s care continuum. Contribute to a positive experience for patients and families through courteous telephone and digital interactions, accurate and expeditious routing, as well as referrals to appropriate clinical staff when necessary
• Collaborate with care teams to establish population-appropriate, pre-visit, and point of care processes
• Completes patient chart preparation a week prior to scheduled patient visit including prior authorizations including, but not limited to, entering all medical, social, and personal demographics, recent labs, medication lists, referral notes, past 2 recent notes, hospitalizations and/or procedures.

Requirements

• Minimum of 1 year experience as a Certified Medical Assistant. Experience in population health preferred.
• Proven problem-solver with ability to multitask.
• Excellent communication skills, both written and spoken.

Preferred Qualifications

• Prior use of Epic
• Experience in Nephrology
• Prior experience with Care or Case Coordination

Benefits

• $17-$19/hr - starting pay range
• PTO
• Health, Dental, and Vision
• Life and Disability benefits
• 401K