Transition of Care Associate

Job not on LinkedIn

🔥 7 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟡 Mid-level

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Lehigh Valley Health Network

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Lehigh Valley Health Network is a comprehensive healthcare system that is now part of Jefferson Health, one of the top 15 not-for-profit health systems in the United States. It offers a wide range of medical services, including primary care, urgent care, and specialized institutes like the Lehigh Valley Topper Cancer Institute and the Lehigh Valley Heart and Vascular Institute. LVHN provides extensive care solutions, including video visits, second opinions, and a network of doctors and clinicians in numerous locations. It emphasizes education through residencies and fellowships and prioritizes patient-centric services such as lab testing and women's health care. The network also focuses on innovation, offering clinical trials and advanced therapies like CAR-T Cell Therapy.

📋 Description

• Conduct post-discharge transition-of-care outreach to patients and families • Link patients to care-management resources and coordinate care with interdisciplinary teams • Conduct telephonic patient outreach and potentially in-person home visits • Foster engagement with new and current patients • Help close care gaps and improve preventive health outcomes using evidence-based practice • Lead the initial setup and ongoing management of post-discharge and care-gap reports • Maintain tracking systems through documentation • Interact with commercial payer groups, individuals, and leadership to drive clinical patient-engagement strategies • Collaborate with nursing teams on engagement tactics, care-coordination barriers, appointment scheduling, and care-gap closure • Organize patient-care activities and information sharing among nursing, ambulatory, and inpatient colleagues • Coordinate patient-engagement guidelines and referrals for ongoing case-management services after discharge • Create and maintain quality data and spreadsheets for reporting and presentations • Respond to client inquiries regarding processes or technical matters • Assist with development and maintain updates to patient-engagement processes

🎯 Requirements

• High School Diploma/GED with required years of healthcare experience OR Specialized Diploma in Medical Assistant or related field • 3 years experience working within a complex health system environment OR less than 1 year experience with Specialized Diploma • Proficient in Microsoft Office applications • Analytical thinking • Ability to handle numerous tasks at the same time • Superior customer service skills • Working knowledge of basic computer functionality • Effective and professional written and verbal communication • Ability to maintain strict confidentiality • Ability to adapt to changing priorities • Critical thinking skills and solution-focused approach • Knowledge of medical terminology • Knowledge and experience with electronic medical records and scheduling software • Preferred: 5 years experience working within a complex health system environment • Preferred: Bilingual • Preferred certifications/licenses upon hire include LPN, CCMA, CMA, CMAC, MAC, NCMA, NRCMA, or RMA • Ability to lift and carry 25 lbs.; frequent sitting/standing and keyboard use; patient care providers may need to kneel, bend, squat, and perform CPR

🏖️ Benefits

• Full-time employment • Day shift • Monday-Friday work schedule with weekend rotation