Community Care Coordinator

Job Description

Job Description

Overview

The Community Care Navigator (CCN) conducts basic health assessments, assists family members and their families / caregivers to identify needs, provides basic health information, and makes appropriate referrals through home visits and telephonic outreach.

The Community Care Navigator (CCN) reports to the Director of Care Coordination. They should embody CINQCARE’s core values, including, Trusted , Empathetic, Committed, Humble, Creative, and Community-Minded.

Primary Responsibilities

The Community Care Navigator (CCN) will have the following responsibilities :

• Responsible for establishing trusting relationships with family members and their families while providing general support and encouragement.
• Travel to family members’ homes to conduct remote physical exams under the guidance of the POD Nurse Practitioner, or RN.
• Provide ongoing follow-up, basic motivational interviewing, and goal setting with family members / families / caregivers.
• Follow up with family members via phone calls, home visits, and visits to other settings where family members can be found.
• Work closely with medical and Behavioral health providers to help ensure that family members have comprehensive and coordinated care.
• Work collaboratively with other clinical personnel assigned to the same family members.
• Responsible for providing consistent communication to Cinq Care Pods and supervisor to report on family member / family status.
• Act as a family member advocate and liaison between the family member / family and community service agencies.
• Record family member care information in the EMR and other software no later than 24 hours after family member contact.
• Help family members set personal health-related goals and attend appointments.
• Knowledgeable about community resources appropriate to the needs of family members / families. Provide referrals for services to community agencies as appropriate.

Help family members connect with transportation and other resources and provide appointment reminders in special circumstances.

• Exhibit excellent working relations with family members, visitors, and staff
• Attend regular staff meetings, training, and other meetings, as requested.
• Always maintain HIPPA compliance.

General Duties

The Community Care Navigator (CCN) will have the following duties :

Leadership : The Community Care Navigator (CCN) will assist in defining strategies and solutions to create business value in care coordination.

Apply and actively share knowledge, expertise, and best practices with the team.

• Strategy : The Community Care Navigator (CCN) : (1) improve outcomes for CINQCARE’s Family Members; (2) Accept and readily adapt to changing priorities, new ideas, strategies, procedures, and methods.
• Collaboration : The Community Care Navigator (CCN) will work closely with other business divisions to learn their needs and internalize their knowledge.

Addresses all CINQCARE’S Family Members’ concerns in a timely and efficient manner.

Knowledge : The Community Care Navigator (CCN) will maintain a strong, effective, ongoing working relationship with assigned CINQCARE’S Family Members.

Maintains competence through continuing education and in-service training.

Culture : The Community Care Navigator (CCN) is accountable for creating a productive, collaborative, safe, and inclusive work environment for their team and as part of the larger Company.

Represents CINQCARE and its subcontractors by displaying a respectful and caring manner to our Family Members and their families.

Qualifications

The Community Care Navigator (CCN) should have the following qualifications :

Education : Associate degree required; B.S. or B.A. preferred or a combination of education and experience.

Travel : Travel is essential in the performance of this role. Reliable car and or willingness to travel on public transportation

Experience : One year in a health services environment. Experience as a Community Health Worker or equivalent preferred.

Familiarity with primary care practices is preferred. Proficiency in all Microsoft Office applications.

Essential Responsibilities

Entrepreneurial : CINQCARE seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations.

This position is accountable for ensuring CINQCARE is positioned to innovatively deliver on its promise.

• Communication : Excellent verbal, written communication, and presentation skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQCARE’s team, investors, partners, and other stakeholders.
• Relationships : Ability to build and effectively manage relationships with business leaders and external constituents.
• Culture. Good judgment, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding, and entrepreneurial Company.

PHYSICAL DEMANDS

Requires sitting and standing associated with a normal office environment. Manual dexterity

needed using a computer keyboard. While performing the duties of this position, the employee is regularly required to talk or listen.

The employee needs to be able to see and frequently is required to use hands or fingers, handle, or feel objects. The employee is frequently required to stand, walk, sit;

and reach with hands and arms. Ability to travel frequently by car and / or public transportation.

Work Environment :

• Will require regular travel to family members’ homes, physician offices, hospitals, sub-acute facilities, community partners, and non-home-based market offices.
• Requires in-home visits.
• The noise level is usually moderate.

Location : Hybrid : Will / May make visits to patient homes, hospitals, facilities, Cinq Care practices and Cinq Care main offices