Western Colorado Pediatric Associates, a division of Primary Care Partners, Inc., is seeking a full-time Care Coordinator. This position is responsible for the care management of a focused group of defined high risk patients under physicians’ direction. The person will use professional communication skills to facilitate between the provider and patient/caregivers. Will help empower the patient/caregiver with self-management of their care and assure patients are following their care plan. The starting pay for this position for Administrative - $16.25 MOA - $16.25 LPN - $18.95

The best candidate will: • Ensure patients with complex needs and likely to benefit from care coordination receive proactive, relationship based care management. o Review risk stratification, enroll patient in episodic or longitudinal, develop care plan, review care plan on a routine basis o Maintain as needed contact during visits and follow up calls. o Notify provider if significant changes in patient’s medical milieu occurs. o Coordinate the preparation and presentation of patient data on these patients. • Referral management: prepare and send and help with tracking and closing. • Knowledge of community resources and services applicable to the pediatric population. • Coordinate and manage the care transitions of high risk patients with other medical offices (specialists), health care facilities, and all community services that are utilized by the patient. • Proactively manage chronic and preventive care for empaneled patients through the use of registries and Eagle Dream. Utilize the help of the back office team and review at IDT’s. o Use data to continuously improve your patients’ health, experience and quality of care, and to decrease cost. o Use data to identify populations or groups of patients with similar needs and challenges to select high priority areas for improvement. • Ensure all patients receive timely follow-up contact from practice after hospitalization to reach metric goals. Assist back office in the timely follow up of ED visits. • Manage chronic and preventive care for empaneled patients. • Conduct regular care team meetings to review quality data. Use the information to guide tactics to improve patient outcomes and value. • Use pre-visit planning, inclusive of all key roles on the care team, to optimize preventive care and care team management of patients, including medical and health-related social needs. • Maintain task bin and complete tasks sent by office personnel • Participate in educational sessions to fulfill the goals and objectives of the program, attend regular meetings with care coordination team and IBHC team, and schedule regular IDTs for each provider. • Review providers’ schedules – obtain newborn records and hospital records as needed. • Assist in finding residential placement for patients and with the transition of patients as they age out of WCPA.

Experience- Two or more years in a medical practice or other health care facility. Coordination of care between the patient and other community resources. Documented experience in communication with diverse groups (e.g. physicians, a health plan, community resources, nurses, patients and families). Must have skills in patient motivational interviewing and exhibiting a positive attitude under stressful situations. Must be able to multi-task and be capable of prioritizing tasks.

Education- Appropriate level of education highly skilled and focused in nursing and/or social work with necessary licensures and or certifications related to the level of education. Attend continuing education programs as requested or required by the position. We offer excellent benefits including Medical, Dental, Vision, Paid Time Off, 401K, Employee Assistance Program, competitive wages, friendly work environment and more.