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Patient Care Coordinator - Home Health (PCC-RI)

Providence, RI, USA

Home Health > Rhode Island > Administrative Operations > Care Coordination

About the Role

The Patient Care Coordinator (PCC) at Elmwood Healthcare - Home Health (Elmwood Home Care) is responsible for overseeing and managing patient care processes to ensure that patients receive high-quality and personalized care in their homes. This role involves coordinating care services, working closely with patients, families, and healthcare professionals, and ensuring that all aspects of patient care are delivered effectively and efficiently.

Department

Administrative Operations > Care Coordination Department

Status / Type

Full Time (40-Hours / Week)

Schedule

Monday through Friday; 8:00 A.M. to 4:30 P.M.

Environment

Office-Based


Key Responsibilities:

  • Care Coordination:

    • Develop and implement individualized care plans in collaboration with healthcare providers, patients, and their families.

    • Schedule and coordinate home visits, therapy sessions, and other services as required.

    • Ensure seamless communication between all parties involved in the patient's care, including doctors, nurses, therapists, and family members.

  • Patient and Family Support:

    • Serve as the primary point of contact for patients and their families, addressing concerns, answering questions, and providing education about care plans and services.

    • Assist families with understanding and navigating insurance benefits and coverage for home health care services.

  • Quality Assurance:

    • Monitor patient progress and care delivery to ensure adherence to care plans and quality standards.

    • Conduct regular follow-up calls and home visits to evaluate patient satisfaction and adjust care plans as needed.

    • Address any issues or discrepancies in care promptly and effectively.

  • Documentation and Reporting:

    • Maintain accurate and up-to-date patient records, including care plans, progress notes, and incident reports.

    • Ensure that all documentation complies with healthcare regulations and company policies.

    • Prepare and submit reports on patient outcomes, service delivery, and other relevant metrics.

  • Team Collaboration:

    • Work closely with a multidisciplinary team, including physicians, nurses, social workers, and other healthcare professionals, to provide comprehensive care.

    • Participate in care team meetings and contribute to the development and review of patient care plans.

  • Administrative Duties:

    • Manage and prioritize administrative tasks such as scheduling, data entry, and correspondence.

    • Assist with the onboarding of new patients and the transition of care between different service levels or providers.

  • Other:

    • Accepts only those patients whose needs can be met by the services it provides;

    • Monitors and responds to electronic referrals via electronic referral systems

    • Verifies and coordinates all insurance benefits of prospective patients (referrals);

    • Creates, oversees and maintains the schedules of approximately 100 patients based on physician orders;

    • Creates, oversees and maintains the schedules of designated team members (clinicians) in correlation to patient needs and staffing variances;

    • Enters scheduling data to create and maintain accurate orders in accordance with care plans;

    • Works inter-disciplinarily to create a consistent flow of high-quality patient care;

    • Contacts care-providers, clinicians and patients with updates regarding day-to-day scheduling matters;

    • Receives, processes and facilitates referrals in accordance with the systematic guidelines set forth by Elmwood Home Care;

    • Accepts only those patients whose needs can be met by the services it provides;

    • Monitors and responds to electronic referrals via electronic referral systems;

    • Verifies and coordinates insurance benefits to safeguard reimbursement of services provided;

    • Works closely with the sales team to process new referrals and disperse updates on pending referrals;

    • Generates reports and data regarding scheduling, care coordination and staffing as designated; 

    • Maintains and updates patient status updates in correlation to provision of home-health services;

    • Monitors and provides feedback on agency care coordination systems and processes;

    • Acts as the bridge between all pre- and post-transitional care processes;

    • Performs performance appraisal and review of department personnel;

    • Provides counseling and/or disciplinary action to department personnel when indicated;

    • Ensures the safety, security, integrity and confidentiality of patient and staff information in accordance with HIPAA and agency standard regulations; 

    • Upholds the standards of patient satisfaction, customer service and quality of care set forth by the agency;

    • Demonstrates an understanding of the operational flow of a Medicare-certified home-health agency;

    • Demonstrates an understanding of the post-acute and transitional-care processes;

    • Understands and adheres to policies, procedures and regulations set forth by the agency;

    • Understands and adheres to policies, procedures and regulations set forth by local, state and federal governments;

    • Accept responsibility for other duties/tasks as assigned, following adequate training on the specific task/(-s) or duty(/-ies).

Qualifications

  1. Education: High-School Diploma or Equivalent is required; Associate’s or Bachelor's degree in healthcare administration, or a related field is preferred.

  2. Experience: Minimum of two (2) years of experience in a healthcare or home health care setting, with a focus on patient intake or coordination is preferred.

  3. Skills:

    • Strong interpersonal and communication skills, with the ability to interact effectively with patients, families, and healthcare professionals.

    • Excellent organizational and multitasking abilities.

    • Proficiency in using electronic health record (EHR) systems and other healthcare software.

    • Knowledge of insurance processes and healthcare regulations.


    • Multi-Lingual - English, Spanish (Required)

    • Believes in a connected emphasis on community-based healthcare and demonstrates, through action and clear core values, a shared passion for the goals, mission, vision and philosophies of Elmwood Healthcare, pillared by quality, innovation, access and equity within community-based healthcare.

Elmwood Healthcare - Home Health

Elmwood Healthcare is looking for a committed, eager, passionate and experienced professional to join the team of highly-skilled individuals within our community-based health system.


Elmwood Healthcare's Home Health Division, Elmwood Home Care, is a multi-setting Medicare-Certified, dual-program Joint Commission accredited organization, providing both skilled medical home health care and non-skilled home care services to hundreds of communities by way of Agency branch locations in Rhode Island and Massachusetts.


Our committment to quality and focus on enhanced, specialized care has been defining in the organic evolution of Elmwood Home Care, and our attention to high-demand and high-acuity care in the home-based setting has allowed us to deliver our reimagined home health care services to thousands of patients already. This focus, in areas such as home-infusion therapy, advanced wound care and wound management, home-safety and falls prevention, to name a few, have been met with enormous success and positive clinical outcomes for our patients and their families.


Such unique and hands-on approaches to clinical care and home-based community health management work to capture Elmwood Healthcare's system-wide emphasis on the key ideals that we embody, including: Innovation; Individual patient-centered approaches to a wide-range of specialty, chronic and acute care; Health equity and access to promote longevity, sustainability and the provision of high-quality care in community-based settings, allowing our community populations to safely and effectively age in place; And, at the forefront, the highest standards in the provision of high-quality community-based care.


Driven by a passion for community health, Elmwood Healthcare believes in the ways that community-based healthcare positively impacts our communities. Through the delivery of unmatched care, a culture of safety and respect, and endless opportunity for personal, professional and career development, we are committed to igniting change within the healthcare industry. Our focus and goal is to bring care back to the patient, and bring healthcare professionals back to doing what they love- caring for others.


Elmwood Healthcare, at large, supports and cares for communities by providing compassionate, innovative and personalized care. Through a comprehensive, community-based systems approach, we are committed to the delivery of the highest-quality of patient-centered care. Through this model, we maximize patient success and reduce hospital re-admissions to promote higher-rates of successful outcomes. For our patients, this is all possible when care is delivered in the comfort of their own home.


The dedication to each patient Elmwood Healthcare cares for goes well beyond the scope of intermittent services, with primary focus on communication, continuity and growth. Holding ourselves, our teams and our partners in the community accountable to the highest standards of care and operational integrity, Elmwood Healthcare champions the promotion of health-equity, access to viable and necessary community resources and enhanced equal opportunities for each patient and each member of our team alike.


Through these core ideals, Elmwood Healthcare places emphasis on personal and professional growth, skill acquisition through continuous hands-on training, and long-term career development within the organization to promote the development of our professionals, thereby supporting and enhancing integrated access to high quality care for our patients and their families.


Our standards are modeled to mirror those of federally-supported accrediting bodies and lead us to our commitment to ongoing and absolute compliance with local, state and federal regulations, allowing Elmwood Healthcare to further promote large scale positive impacts on our communities.


The execution of our philosophies and missions solidify Elmwood Healthcare as a pioneer community-based healthcare innovation. Pillared by models that emphasize patient-centered approaches, our goals focus on upholding quality, safety, access and equity in healthcare. Elmwood Healthcare emboldens an evolving and limitless vision of opportunity that seeks to continually empower our patients and families, our team-members and our partners in the communities that we serve.

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