Specialty Care & Acuity Coordinator

Position Summary

Focused on specialty care referrals, Medicaid eligibility and collaboration with FQHC Medical Directors and lead care managers. developing on specialty care planning, specialty care appointments, data collection on specialty referrals and collaboration with providers to improve access to specialty care. Support DPP coordination of care to acutely ill patients with complex, acute, and often co-existing chronic illnesses both by working independently and as a member of an interdisciplinary team.

Primary Responsibilities include:

• This is a position dedicated to our community-based diabetes program which coordinates efforts between clinical teams, coordinators, and sub-specialists for our DPP.
• A solid understanding of diabetes and diabetes education is an essential component of this role.
• Focused on improving specialty care referrals and primary care/preventive care access.
• Coordinating referrals, tracking, and monitoring of access to specialty care and primary care for DPP participants.
• Will lead the implementation and coordination for patients from each FQHC to understand their diabetes, supports for self-management practices and desired improvements, and provides access to specialty care and primary care providers.
• Provides clinical and programmatic oversight and supervision to Qualified Professional, Team leaders, who are providing behavioral health services on regional basis.
• Assists in the evaluation of high-risk behaviors on an emergent and routine basis.
• Relies on extensive expertise, knowledge, experience, and judgment to supervise the coordination of prevention and outreach to patients at risk for Type 2 diabetes or that currently have diabetes.

Essential Duties

• Manage and coordinate referrals, outreach activities, workflow and diabetes prevention resources of the collaborative and its key stakeholders.
• Develop specific goals, standards, and objectives which directly support the strategic plan and vision of the collaborative to address diabetes prevention and specialty care access.
• Coordinates and monitors the referrals and waitlist for diabetes prevention program.
• Work closely with community health center and specialty care staff to maintain communication and provide feedback and standardize procedures.
• Identify new opportunities for cross-sector collaboration that support program implementation or address social determinants of health.
• Perform other duties as assigned.

Education and Experience

• Bachelor of Science in Nursing (BSN) or Master of Science in Nursing (MSN)(preferred)
• Bachelor's degree in a field related to the program and two years of related experience, or an equivalent combination of education, training, and experience.
• Two years of experience working in health research, public health programs and/or community-based organizations that provide health services.
• Experience with diabetes programs preferred
• This is a position dedicated to our community-based diabetes program.
• Experience in reporting, data management, excel and google sheets a must.
• The position requires a candidate to be competent in understanding of quality metrics, outcomes and dashboard development and management. A solid understanding of diabetes and diabetes education is an essential component of this role.
• Able to handle multiple tasks at once, meet deadlines, detailed, flexible, able to manage relationships.
• Excellent organizational and interpersonal skills.
• Ability to work independently.

Clinify Health is an Equal Opportunity Employer.