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Chronic Care Management (CCM) Coordinator - MI

Department: HealthXL
Location: Dearborn, MI

Overview

Currently recruiting exceptional, credentialed Medical Assistant or higher to join our team as a Chronic Care Management (CCM) Coordinator in the Dearborn, Michigan Care Center. The ideal candidate is comfortable providing telephonic Chronic Care Management (non-face-to-face) services as an extension of the clinical staff of physician practices managing patients with 2 or more diagnosed chronic conditions.

This role includes navigating multiple EMR platforms, constructing a proprietary comprehensive care plan, and providing a range of care coordination services, including but not limited to, monthly health interviews with patients, coordination with family members and caregivers, and working with community services to ensure access to care. This position works under the supervision and guidance of the Care Center Manager.

*Full & Part Time Opportunities Available

Responsibilities

  • Meet production goals based on part-time or full-time hours.
  • HIPAA compliant use of computer access (need to know only) to facilitate patient care.
  • Create and maintain comprehensive, proprietary patient care plan.
  • Use proprietary care plan to guide patient interaction and direction.
  • Utilize chronic condition specific scripts to guide conversation.
  • Review individual care plans and make monthly phone calls to CCM enrolled patients.
  • Calls may include:
    • Assess current health status
    • Medication reconciliation & compliance assessment
    • Appointment reminders
    • Appropriate patient education re: care & condition management at home
    • Review orders, labs, consults and associated documentation
    • Encourage preventative health services
  • Thorough documentation in care plan reflecting updated information, test results, social.
  • Manage the flow of information to/from providerís office.
  • Facilitate three-way call when necessary.

Qualifications

  • Medical Assistant certification or higher (LPN, RN, BSN, etc.)
  • Minimum 1-year experience in home-care or clinical setting.
  • Minimum 1-year experience in Chronic Care Management.
  • Knowledge of medical terminology.
  • Critical thinking skills.
  • Ability to assess status of conditions remotely.
  • Quickly recognize condition-related warning signs.
  • Organized, thorough documentation skills.
  • Self-directed. Ability to prioritize responsibilities. Demonstrated time management skills.
  • Clear diction. Applies exemplary phone etiquette to every call.
  • Committed to excellence in patient care and customer service.
  • Demonstrated communication/listening skills.
  • Ability to navigate effectively in multiple computer programs.
  • HIPAA compliant area in home to conduct Chronic Care Management duties.
  • Ability to lift 50+ lbs.
  • Ability to stand/walk up to 100% of shift
  • Frequently required to walk, reach with hands and arms, stoop, kneel, crouch

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