About Job

Summary

The Fortify Children’s Health Care Coordinator utilizes their skills and knowledge base to support the optimal health and wellness of the pediatric patient. Through telephonic outreach, the care coordinator will communicate with patients’ families to complete assessments and develop individualized care plans that best support the medical and social needs of the patient and family. Highly developed written and verbal communication skills that facilitate patient/family understanding of health needs is essential. The Fortify Care Coordinator provides education, support, referrals, advocacy, and ongoing care coordination to support patient and family wellness. This position requires strong organizational skills in order to multi-task and prioritize referrals, assignments, and requests. The successful candidate has a demonstrated track record of building respectful rapport and trust with patients, families, providers and community partners; completing assessments of physical and psychosocial needs; identifying appropriate healthcare and community resources; collaborating with team members. This position requires confidentiality, discretion, and compassion.

Provides care that is inclusive and respectful of socioeconomic status, race, ethnicity, age, mental or physical disability, religion, gender, sexual orientation, or national origin.
Builds open, trusting, respectful relationships with diverse patients and families both remotely and in person.
Engages critical thinking skills to support the development and execution of Individualized Plans of Care.
Anticipates and responds to patient and family needs.
Communicates effectively with diverse audiences both orally and in writing.
Works with interdisciplinary teams to improve patient, family, and community outcomes.
Electronically documents care according to industry and institutional standards, including HIPAA-compliant documentation.
The job includes the following essential functions:

Assisting with biopsychosocial assessments and identification of medical and social needs for patients and families.
Reading and implementing an Individualized Plan of Care and evaluating progress towards identified goals.
Engaging in ongoing communication to interdisciplinary care team members and other partners to provide progress on care needs, referrals, barriers, and outcomes
Identifying relevant community resources to benefit patients and families.
Completing and following-up on referrals to community resources to optimize effective and efficient care outcomes in collaboration with other members of the multidisciplinary team.
Building relationships with schools and other community partners to facilitate seamless referral and care coordination.
Engaging in continued personal professional education regarding Care Management best practices.
Consistent documentation that meets care, regulatory and accreditation requirements.

Bachelor’s degree in a Health or Human Services field.
2+ years of relevant professional experience, preferably in care coordination or social work.
Strong understanding of care coordination best practices.
Proficient computer skills.
Experience working with children, families, and community partners.
Strong organizational skills and the ability to work independently.
Excellent communication skills and the ability to interact with diverse individuals; Bilingual a plus.
Prior experience working with Medicaid population.
Experience conducting medication reconciliation with patients and identifying discrepancies.
Experience communicating with medical providers regarding patient needs.
Comfort working in a fast pace and dynamic “startup” environment.