|Department:||Clinical Support Services|
|All:||2221 E. Bijou|
Taking Health Care to New Heights
Peak Vista Community Health Centers provides exceptional healthcare to people facing access barriers.
We are a private nonprofit dedicated to premier medical, dental and behavioral health services for people of all ages. We provide primary care services to residents of the Pikes Peak Region through 19 outpatient health centers and are accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC).
Job Summary (Essential Functions)
Helps provide access to the right care, at the right time, in the right order, in the right setting with the right documentation. Responsible for assisting high-risk patients in achieving maximum wellness through a collaborative, interdisciplinary process involving the patient, family and/or care-givers as well as providers and other clinical support staff. This process includes assessment, planning, facilitation and advocacy. Through communication and the identification of available resources, assists high-risk patients in identifying and obtaining services necessary to meet their physical and emotional needs. This will in turn promote quality and cost effective outcomes. High-risk factors may include more than one of the following:
- Poor pain control
- Previous home health and durable medical equipment usage
- Suicide risk
- Chronic, catastrophic, terminal illness
- History of abuse, neglect, no known social support
- Lives alone, homeless
- Transitional needs to a post-acute facility
- Poor nutritional status
- Financial concerns
- Repeated emergency department visits and or hospitalizations,
- Low functional status or cognitive deficit
- Co-morbid health conditions
- Mental illness or substance abuse
- Pervasive history of noncompliance.
Assesses clients’ psychosocial needs including health literacy status and care deficits (safety concerns and home layout barriers) and makes the appropriate referral for services; Assesses patient’s willingness to change. Coordinates service planning with client, family, or caregiver to maximize health care responses; Facilitates access to quality and cost effective care. Coordinates and follows-up on referrals. Advocates and builds rapport with community agencies; Coordinates communication with members of the health care team and educating the client, family or caregiver and care team about treatment options and community resources as well as psychosocial needs and socioeconomic status and deficits. Coordinates care with the Emergency Diversion team. This position may involve driving to client’s homes for assessment and follow-up and accompanying patients to off-site appointments as needed. Scope of authority includes: providing resource coordination, follow up, patient education, and self-management education services to patients and to serve as a consultant to medical staff and requesting support from professional staff when required. Performs other duties as assigned.
Supervision Received: Manager of Care Coordination
Supervision Exercised: N/A
Education: Minimum 4 year degree in human service field or related medical field or equivalent experience/licensure required. Prefer Master’s degree in human service field or related medical field.
Work Experience: Three years experience in case management, crisis intervention or client-centered counseling and extensive knowledge of community resources required.
Cognitive Skills (Language, Math, Reasoning Ability): Excellent language, reasoning and thinking abilities. Bi-lingual (Spanish) preferred.
Computer Skills: Word, Excel, Electronic Health Record
Other Skills: Knowledgeable of community resources, sensitivity to low income and diverse groups of people, ability to work with families from a strengths-based model and strong interpersonal skills. Self-motivated. Valid driver’s license and insured automobile required. Must be able to work a flexible schedule including some evenings.
Certificates & Licenses: N/A
Frequent standing and walking, occasional long periods of sitting, moderate bending, moderate energy requirements and fine motor skills. Looking at computer screen continuously for long periods of time, hearing within normal range. Able to travel from clinic to clinic as required and make home visits as needed. Must be able to lift 20 pounds.
If you are an individual with disabilities that needs accommodation and are having difficulty using our website to apply for employment, please call us at (719) 632-5700 and ask for the Human Resources Department.
For employment and benefits information as well as additional employment opportunities, click here