Chronic Care Management Coordinator

DescriptionTeche Health, A Federally Qualified Health Center, per Section 330 of the Public Health Service Act, is currently seeking qualified applicants for a Chronic Care Management Coordinator in Franklin, Louisiana.

JOB SUMMARY:

The Chronic Care Management Coordinator (CCM Coordinator) Provides care management for adult and pediatric patients with complex illnesses, in the primary care setting, under the Supervision of the Chronic Disease Project Manager. In partnership with the primary care practice leadership team, the CCM Coordinator leads care management within the team through process improvement, workflow redesign, helping with training, and delegating to other members of the team. Serves in an expanded health care role to collaborate with specialists, members of health care team, and patients/families to ensure delivery of quality, efficient, and cost-effective health care services. Assesses plans, implements, coordinates, monitors, and evaluates all options and services with the goal of optimizing the patient's health status. Integrates evidence-based clinical guidelines, preventive guidelines, and protocols, in the development of individualized care plans that are patient-centric, promoting quality and efficiency in the delivery of health care. Provides other duties as assigned by Chronic Disease Project Manager.

Provides targeted interventions to avoid hospitalization and emergency room visits. Coordinates care across settings and helps patient/fam