Care Coordinator - Napa

Care Coordinator

Department: Care Coordination

Reports To Title: BH Manager, Care Coordination

Location: South Napa Campus

Pay Range: $29.32 to $35.83/hr (depending on years of care coordination experience)

Schedule: Monday to Friday, 8am to 5pm (full time)

DLSE/FLSA Status: Exempt/Salaried position

Supervisory Responsibilities: NO

About CommuniCare+OLE: Established in 2023, CommuniCare+OLE is the result of a union of two health centers with a deep roots in their respective communities and reputations for providing high-quality primary care to all, regardless of insurance or ability to pay: OLE Health of Napa and Solano Counties and CommuniCare Health Centers of Yolo County. Building on a legacy established by both organizations in 1972, CommuniCare+OLE is a network of federally-qualified health centers with 17 sites across Napa, Solano, and Yolo Counties. It offers comprehensive care, including medical, dental, behavioral health and substance use treatment, nutrition, optometry, pharmacy, care coordination, referrals, and enrollment assistance to more than 70,000 individuals, and no one is turned away due to lack of insurance, immigration status, or ability to pay. Many services are offered outside of its sites, including mobile health, home visiting, and community and school-based programs.

Benefits: Medical, Dental, Vision Coverage Employer covers 90% of employee medical, dental and vision premium and 50% of dependent premium 18 days of PTO (Vacation & Sick) 10 Paid Holidays + 1 Float Holiday 2% employer match with employee 4% Contribution 403(b) retirement plan Tuition Reimbursement of up to $2,000 per Calendar Year for part-time and full-time employees (prorated per Full-Time Equivalent) Life & Accidental Insurance Coverage Employer contribution for Health Savings Account

Job Summary/Overview: The Care Coordinator works in continuous partnership with the patient, their family when appropriate, their care team, and relevant community partners to improve health outcomes and meet the patient's desired health and wellness goals by: Serving as the contact point, advocate, and informational resource for patients, family/caregiver(s), primary care team, payers, and community resources Facilitating access to internal and external services Identifying and addressing gaps in care and assessing for social determinants of health Increasing patient's ability for self-management and shared decision-making

CommuniCare+OLE provides an inclusive workplace that promotes and values diversity and life experience. CommuniCare+OLE encourages people of all backgrounds to apply including, but not limited to, Black, Indigenous Peoples, people of color, immigrants, refugees, women, LGBTQIA+, people with disabilities, veterans, individuals of all ages and religions, and individuals who have been affected by the legal system. You are welcome here.

Minimum Position Requirements: Education, Experience, Skills/Training Education: High School Diploma or equivalent. Experience/Lived Experience: Experience working with diverse populations displaying respect and sensitivity to diversity, equity and inclusion preferred Experience working in a community health setting preferred Experience working with complex patient situations a plus Special Skills/Training: Strong verbal and written communication skills required; Bilingual (English/Spanish) required. BLS Certification required. Strong collaborative skills: ability to effectively and appropriately engage members of the care team, other clinic departments, leadership, and external community partners.

Essential Functions and Responsibilities 1. Evaluates social determinants of health, identifies barriers to care and addresses/resolves obstacles impeding progress 2. Processes and closes the loop for community resource referrals 3. Provides warm hand-offs for urgent and stat medical referrals and collaborates with referral coordinators to ensure medical referrals are processed 4. Works with direct supervisor and QI department to ensure quality improvement initiatives are met 5. Meets with each new patient and orients patient and family/caregiver(s) to CommuniCare+OLE 6. As a member of the care team, participates in huddles, team meetings, and case conferencing as needed 7. Educates patient and family/caregiver(s) about relevant community resources 8. Coordinates warm hand-offs for integrated care providers 9. Provides support to primary care providers by completing forms and other tasks as needed 10. Provides care management and creates care plans for patients on high-risk registry. 11. Documents timely and efficiently in the EMR 12. Care manages and documents as per Enhanced Care Management (ECM) processes, a percentage of patients on the high-risk registry determined by the BH Manager, Care Coordination. 13. Covers care coordination duties for colleagues who are out of the office 12. Attends appropriate training courses/webinars and meetings 13. Gathers and reports data related to aspects of care coordination when needed 14. Provides feedback for the improvement of Care Coordination processes 15. Performs other duties as assigned.