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POPULATION HEALTH COORDINATOR

Methodist Health System - Dallas, TX
Full-time 8-4:30 Day
Your Job: Population Health Coordinator carries a caseload taken from a population of individuals whose disease acuity has been determined to be low, using a stratification process that incorporates data from available encounter, claims, lab, medication, and admission databases. Working closely with clinical support staff, nursing leadership, physicians, quality department, and the information technology department, the Population Health Coordinator is tasked with achieving system goals of improving health and clinical outcomes for patients by using timely and appropriate coordination of quality healthcare services to meet an individual's specific health needs to promote positive outcomes.Your Job Requirements:LVN or MA requiredMinimum of 2 years clinical experience.Health education or weight management background preferred.Current BLS certification required, ACLS preferred.Demonstrated knowledge and experience with behavior change, as well as, self-management and motivational interviewing techniques.Excellent communication and interpersonal skills.Good oral, written and presentation skills. Bilingual (English/Spanish) a plus.Proficient computer skills including data entry, retrieval and report generation; experience documenting in an Electronic Medical Record preferred.Ability to use good judgment and critical thinking skills; ability to identify and resolve problemsAbility to interpret, adapt, and apply guidelines and protocolsAbility to establish and maintain effective working relationships with patients, families, medical staff, and co-workersAbility to work independently, while collaborating with other team membersAbility to self-motivate, prioritize, and be willing to invest in a change process to improve efficienciesAbility to work with a diverse patients/family populationExperience in provision of Primary Care with this population is highly desirableYour Job Responsibilities:Promote patient self-management and empowers patients/families to achieve maximum levels of wellness and independenceAssist patients in setting SMART goals for self ?management, teaching them how to do self-management tasks and report abnormal findings to their physician team;Collaborate with the patient, physician, and other care team members in assessing the patient's progress toward individual health care goals;Assess barriers when patient has not met treatments goals, is not following treatment plan of care, or has not kept important appointments;Oversees the development, procurement, and adoption of patient self-management educational resources used by the primary clinical teamsCollaborate with physicians, providers, and practice staff in identifying appropriate patients for more intensive care managementDevelop relationship with patient as an integral member of teamResponsible for being available to provide telephone advice per protocol, handle urgent calls and emergent callsResponsible for working with patient and patient's care team to coordinate change readiness, needs assessment and develop an individualized treatment care planParticipate in regular team meetings and peer review activities. Participates in departmental and organizational committees as applicable.Promote collaborative teamwork; able to work with peers in a team situationCollaborate with payer Case Managers for additional services when appropriateDevelops a list of medical supply and community resources available to patients and maintains collegial relationships with the entities used most frequently;Consistent documentation of patient self-management measures, mutually agreed-upon care plan that is efficiently available to all and reporting of progress towards goals